Read the following two scenarios and respond to the questions in each:
Part A
A 28-year-old comes to your office with a chronic cough. The cough and wheeze have been present two to three days a week with two to three nights a month as well. This has been going on for approximately a year intermittently with treatment for bronchitis for which there have been antibiotics and cough suppressants. It never seems to get better. There is no SOB or difficulty speaking noted during the exam. On auscultation, you hear expiratory wheezes, high pitch, throughout all fields. There are no medication allergies or environmental allergies. You suspect asthma.
Based on guidelines, how would this asthma be classified? Why?
Using rational drug selection, what pharmacological agent/s would you begin with and why?
Discuss teaching related to possible side effects.
Part B
A 54-year-old comes to your office with a 30-year history of tobacco use. There is an increase in cough of late, with copious productive white clear sputum. The patient relays shortness of breath at work and with walking around the house. During the exam, the patient leans forward to talk and also states that sleeping flat has become uncomfortable. You suspect COPD.
Describe the physiology of COPD.
Using COPD guidelines, describe your pharmacological treatment with rationale.
What considerations regarding socioeconomics, drug profiles, and management must you make?
Describe a teaching plan that includes lifestyle and prescription considerations.
Summarize your answers in a two-page paper. Using APA formatting, integrating three evidence-based resources to include clinical practice guidelines as well as the course textbook.
Course Textbook we are using is:
Pharmacotherapeutics for Advanced Practice Nurse Prescribers by Woo & Robinson, 4th Edition.