Question 1: Week 2 DiscussionReply to one of the following prompts.In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.Prompt 1:Jennifer is a 25-year-old female who has the complaint of worrying excessively, feeling restless, difficulty concentrating and feeling fatigued for the last 6 months. She is under considerable stress trying to juggle work, taking college classes, and raising her 2 young children. After running some lab tests including a TSH (which were all normal), you diagnose her with generalized anxiety disorder. What pharmacological and non-pharmacological interventions could you recommend to help treat her anxiety? Are there any medications that you would avoid for this patient? Are there any tools that can help you screen your patients for anxiety in case they don’t feel comfortable admitting to you that they are anxious? How would you follow up with this patient?Prompt 2:Emily is a 44-year-old woman who presents with a 6-week history of initial insomnia and a 10-pound weight loss. She admits to feeling sad almost every day since she lost her job 6 weeks ago. She has no interest in engaging in previously enjoyable activities. She denies suicidality (ideation or plan). She has never been treated for depression. Her physical examination is negative, vital signs and blood work including a thyroid profile is all within normal limits, and her body mass index is 22. Her mother has a history of depression, and she was treated successfully with Sertraline. What medication should be considered for Emily and why? Does her age and childbearing potential influence your treatment decision? Is medication therapy enough? Please include medication education in your discussion.Prompt 3:James is a 51-year-old male truck driver with a long history of diabetes and hypertension. His current medication regimen is Lisinopril 20mg QD, metformin 1000mg QD, Lipitor 40mg QHS, and ASA 81mg QD. His A1C is 7, BP is 144/80, total cholesterol is 266, HDL 44, LDL 177, and Trig 199. What other information should you know about this patient to feel confident that his care is well optimized? What parameters would you like to see improved? To what clinical guidelines should you adhere when managing this patient? Are there any changes to treatment you should consider? Support your decisions with evidence.Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.Question 2: Week 2 Discussion Part 2Reply to one of the following prompts.In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.Prompt 1:Jana, a 36-year-old single mother of three children, has a 15-year history of asthma. For the past month, she has been using albuterol every day. Previously, she had been using the inhaler every 3 to 4 months. She is in the office for a refill. What further information is needed to treat this patient and why? What clinical guidelines should you refer to for her medication management and why?Prompt 2:Dave is a 47-year-old male patient in for a follow-up visit to discuss his chronic allergic rhinitis and nasal congestion. He takes Claritin 10mg daily which seems to help his clear runny nose and itchy eyes. However, he complains of chronic nasal congestion and difficulty breathing through his nose. You find out he has been using over-the-counter nasal spray twice a day for several months. What do you think is contributing to his chronic nasal congestion? How would you manage this patient going forward?Prompt 3:Lester is a 67-year-old male who is prescribed Warfarin for his new onset atrial fibrillation. He is concerned about starting this medication and admits he is forgetful about taking meds and doesn’t understand why he must have follow-up blood tests. Discuss the patient education you would offer about Warfarin (include side effects). How would you address his concerns and questions? How can you ensure your patient education information is accurate and up to date? Are there other medications that you could consider for Lester?Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
