Scenario Prescription Errors Explained for Students (Easy Guide)
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This question relates to scenario prescription errors and requires a structured academic response.
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Break the problem into smaller parts and analyze each logically.
Key Explanation
This topic involves scenario prescription errors. A strong answer should include explanation, application, and examples.
Original Question
Scenario 1: Prescription Errors Linagliptin 5 mg PO daily #30 5 RF Errors: Spelling error in the drug name (should be “Linagliptin”). Corrected: Linagliptin 5 mg PO daily #30 0 RF (Renal Function Text might not be provided with this medication’s refills). Classification: Dipeptidyl peptidase-4 (DPP-4) inhibitor. Mechanism of Action (MOA): Enhances the body’s ability to lower blood sugar by blocking the breakdown of incretin hormones. Tresiba inject 10 units SC TID with meals #1 box of 5 pens 1 RF Errors: Tresiba is an insulin meant for once daily dosing, not TID; use with meals is inappropriate. Corrected: Tresiba inject 10 units SC once daily #1 box of 5 pens 1 RF. Classification: Long-acting insulin. MOA: Provides continuous insulin release to manage blood glucose levels. Tiotropium (Spiriva) 2.5 mcg PO BID #60 1 RF Errors: Administration route is incorrect; it should be inhaled. Corrected: Tiotropium (Spiriva) 2.5 mcg inhaled once daily #30 1 RF. Classification: Anticholinergic bronchodilator. MOA: Blocks muscarinic receptors in the lungs, relaxing airway muscles. Qulipta 60 mg PRN for migraine #30 1 RF Errors: PRN is not appropriate for medications used to prevent migraines. Corrected: Qulipta 60 mg PO daily #30 1 RF. Classification: CGRP receptor antagonist. MOA: Prevents migraines by blocking CGRP receptors involved in migraine initiation. Levothyroxine 88 mg PO daily #30 5 RF Errors: Dosage is too high, should be in micrograms (mcg). Corrected: Levothyroxine 88 mcg PO daily #30 5 RF. Classification: Thyroid hormone replacement. MOA: Replaces deficient thyroid hormone, enhancing metabolism. References: Dubbs, L., & Mohr, K. (Eds.). (2020). Clinical Pocket Reference for Nurses, 3rd Edition. Wiley-Blackwell. Lexicomp, “Drug Information Handbook,” 28th ed., Wolters Kluwer. American Diabetes Association. (2021). “Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes.” Scenario 2: Asthma Management for PK Current Situation: PK’s use of albuterol more than twice a week and nighttime symptoms indicate her asthma is not well controlled. Treatment Plan: Medication Adjustments: Increase Flovent HFA from 44 mcg two puffs BID to 110 mcg two puffs BID to better control inflammation. Continue Albuterol MDI as prescribed. Complete Medication Order: Flovent HFA 110 mcg, 2 puffs BID. Albuterol MDI, 2 puffs Q 4-6 hr PRN. Monitoring Effectiveness: Evaluate symptom frequency and peak flow readings in 1 month. Record inhaler usage to assess control improvement. Patient Education: Proper inhaler technique demonstration. Asthma action plan based on symptoms and peak flow measurements. Warning signs that warrant medical attention. References: Global Initiative for Asthma (GINA). (2021). Global Strategy for Asthma Management and Prevention. National Asthma Education and Prevention Program (NAEPP). (2020). Focused Updates to the Asthma Management Guidelines. British Thoracic Society. (2019). BTS/SIGN British Guideline on the Management of Asthma. Scenario 3: Hypertension Management for ES Current Situation: ES occasionally takes bisoprolol due to side effects; BP is not controlled. Patient Information: Explain the importance of consistent medication adherence to prevent complications such as a heart attack or stroke. Discuss side effects and address concerns (e.g., fatigue, dizziness) by considering another medication. Goal BP: Per the American Heart Association, his target should be less than 130/80 mmHg. Hypertension Treatment Guidelines: JNC 8, ACC/AHA: Lifestyle changes as first-line approach, including diet and exercise. Medications per guidelines include ACE inhibitors, ARBs, thiazide diuretics, and calcium channel blockers. Improved Treatment Plan: Switch from bisoprolol to a newer antihypertensive with fewer side effects. Medication Order: Losartan 50 mg PO daily (ARBs are generally better tolerated). Follow-Up: Reassess BP in 2-4 weeks post medication change. Regular patient appointments for blood pressure monitoring. References: Wright, J. T., et al. (2014). “Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8).” JAMA. Whelton, P. K., et al. (2018). “2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.” Hypertension. American Heart Association. (2021). Reviewed by experts specializing in research and evidence-based guidelines. Scenario 4: Diabetes Management for TF Goal A1C: For a 60-year-old with renal issues, the A1C target is generally <7.5%, considering risk factors. Current Status: Fasting BG and A1C indicate inadequate glucose control. Renal function (eGFR 28) complicates medication choice. Treatment Recommendation: Canagliflozin Contraindications: Not recommended due to renal function impairment (eGFR <30 ml/min/1.73m²). Alternative Suggestion: Glipizide: Initiate Glipizide 5 mg PO daily (appropriate for renal impairment). Consider a GLP-1 receptor agonist with renal monitoring if weight management is also desired. Monitor and Education: Regular BG checks and foot inspections due to the risk of diabetes complications. Educate the TF on the signs of hypoglycemia and lifestyle changes that impact glucose levels. References: American Diabetes Association. (2021). "Standards of Medical Care in Diabetes." Diabetes Care. Bristol-Myers Squibb. (2020). "Glucotrol (glipizide) prescribing information". Kidney Disease: Improving Global Outcomes (KDIGO) Guidelines. (2020). "Diabetes Management in Chronic Kidney Disease." These references provide detailed information that would be of great benefit for understanding and guidance in these medical scenarios. I need to put it in APA format with citation and a human writing essay
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