PRESCRIBE MEDICINE CASE

Prescribe Medicine Case

Prescribe Medicine Case

Introduction

A patient goes to the doctor complaining of marked changes in mood between extreme elation or happiness and severe depression. What should the doctor prescribe? Perhaps the doctor should rule out the symptoms as stress and suggest that the patient goes on vacation. Perhaps the doctor should recommend the patient to another hospital department. Perhaps the doctor should prescribe some strong medicine for the patient to relieve their symptoms. On the other hand, perhaps the physician should consider the possibility of a mental disorder and treatment, not a disease but rather as an imbalance.

Background

History

Note: It is 40 years old, 5 feet 7 inches, 148 pounds (67 kg) African American women admitted through the emergency department (ED) with loss of consciousness, possibly related to a drug overdose. He was later transferred to the medical and surgical facility with a medical diagnosis of kidney failure and rhabdomyolysis due to immobility and cocaine. Their stories are measured from her boyfriend. Past medical history including liver disease and kidney failure. Past surgical history is unknown. She is allergic to penicillin (PCN), with a reaction of hives.

Psychosocial, who lives in an apartment in the center of the city with her boyfriend and has no children. She has a history of alcohol abuse and multiple substance abuses, especially alcohol, heroin, cocaine and marijuana. No use of herbal remedies or snuff, but the occasional use of a multivitamin. The system of regular medication patient is uncertain because of patient sedation and ignorance of the groom. In addition, a history of present illness could not be determined for the same reason. It is suspected that liver disease due to chronic alcoholism. His rhabdomyolysis has been associated with immobility and the use of cocaine.

Lab Results

His initial laboratory results included an elevated CPK and tested positive for cocaine, opiates and benzodiazepines. If these results are prescription drugs or illicit drug use is unknown. More recently, his laboratory values were: Na 2 + = 138, K + = 4.2, Cl = 100, CO2 = 28, Ca2 + = 9.8; CPK = 197, BUN = 15; CRE = 1.1, and glucose blood = 105. All who are within normal levels, with the exception of CPK and the CO2 is slightly high (Myers, 15-21). Many drugs have been prescribed since joining a month ago with the most current listed in the Appendix.

Drugs

Heparin

Although the patient was admitted with signs of thrombosis, became increasingly susceptible to its development and long stay in the hospital and remained on bed rest. As a result, an anticoagulant (heparin) is given 5,000 units SQ q 12 hours for the prevention of deep vein thrombosis (DVT). This dose falls within the normal range of adult treatment of 5,000 units q 1208 hours for the prophylaxis of thromboembolism (Hodgson R and Belgamwar R 2006). Works in the intrinsic pathway of coagulation by combining with antithrombin III to inhibit the conversion of prothrombin into thrombin and therefore inhibiting blood coagulation (Radley DC et al ...