Discussion Board of Advanced Pharmacology
Reply 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.
1. Nancy is an 18-year-old female who is sexually active with multiple partners. She presents to the clinic with painful blister-like sores on the vagina, pain when having sex, and a foul-smelling vaginal discharge for the past two weeks. She is diagnosed with genital herpes and chlamydial infection. Describe your treatment plan for Nancy and for her multiple sexual partners. How should you assist Nancy in getting her sexual partners to come for treatment? What are your obligations to report sexually transmitted diseases?
2. Nolan is a 55-year-old male with a 5-day history of nasal congestion, rhinorrhea, malaise, and an irritating sore throat. His nasal discharge has gone from clear to yellow in color. He took OTC acetaminophen at the onset of symptoms with minimal relief. He has no health history and his examination in your office today is unremarkable. He has already missed 2 days of work and insists he needs an antibiotic. He adds that he “always gets an antibiotic” when he sees the other clinician in your clinic. When looking at his chart, you confirm this to be true. You have diagnosed Nolan with a viral URI. What medication treatment plan do you recommend if any?
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Discuss your patient education and outcome evaluation for this patient. What does the literature say about the overprescribing of antibiotics?
3. Jessica is a 35-year-old female who presents to the clinic with a 2-day history of fever (temp 101.4), purulent nasal discharge, and erythema/warmth/tenderness to palpation to her left maxillary sinus area. She also states that her “teeth ache” on the left side and that her face hurts worse when she bends down to tie her shoes. She had started with a mild cold a couple of weeks ago and thought she was getting better but then 2 days ago she started feeling much worse. You diagnose Jessica with bacterial sinusitis. She states that she has always gotten a Z-pack prescription for her sinusitis in the past. What would your treatment plan be for this patient? How will you decide which antibiotic to prescribe and how long she will need to take it? What non-pharmacological treatments can you offer her to help her feel better?
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. In your peer replies, please reply to at least one peer who chose a different topic.
Textbook:
Pharmacotherapeutics For Advanced Practice Nurse Prescribers
• Author: Woo, T. & Robinson, M.
• Publisher: F. A. Davis
• Edition: 5th
Discussion Board of Advanced Pharmacology
Sexually transmitted infection is an ailment that is passed from one person to another through sexual contact. The transmission can also occur through the skin to skin contact in cases of herpes and HPV (Kassa et al., 2019). This paper is focused on Nancy, an 18-year-old girl who came to the clinic with a severe blister-like sore in her vagina and was diagnosed with chlamydia and genital herpes. It addresses Nancy’s treatment plan and her sexual partners. It also explains how the patient might persuade her sexual partners to seek medical attention, as well as my responsibilities in reporting STIs.
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Chlamydia and genital herpes can be managed by antiviral medications and antibiotic (Tuddenham et al., 2019). The goal of treatment is to reduce the symptoms of the infection and prevent the spread of the disease. While antiviral is the primary treatment for chlamydia and genital herpes, drugs such as Zithromax and Doxycycline can be prescribed to prevent other infections. Besides several antiviral medications are available for the management of both chlamydia and genital herpes. In the initial stages of infection, drugs such as acyclovir 400mg PO t.i.d, valacyclovir 1g PO bid, and famciclovir 250 mg PO tid can be prescribed. But in cases of the recurrent episode, drugs such as Valtrex 500mg or Famvir 250 PO bid X 12 months can be prescribed. In severe instances requiring hospitalization, IV acyclovir should be administered (Bhatia et al.,2022). Moreover, before prescription, patients’ allergies and undesirable pharmacological reactions must be evaluated. In cases of resistance, drugs such as foscarnet 80 mg/kg IV q8H may be used.
The patient should be encouraged to be open and honest regarding her diagnosis with her sexual encounters. The patient should be informed of the need of informing their partners about their condition and the necessity for therapy. STIs are a major public health concern and should be reported to health authorities whenever they are suspected. All nurses have a responsibility to report any suspicion of an STI, even if the patient does not appear to be symptomatic. Nurses who suspect an STI in a patient should take appropriate steps to confirm the diagnosis and counsel the patient about how to prevent further transmission.
References
Kassa, D., Gebremichael, G., Tilahun, T., Ayalkebet, A., Abrha, Y., Mesfin, G., … & Assefa, Y. (2019). Prevalence of sexually transmitted infections (HIV, hepatitis B virus, herpes simplex virus type 2, and syphilis) in pregnant women in Ethiopia: trends over 10 years (2005–2014). International Journal of Infectious Diseases, 79, 50-57.
Tuddenham, S., Hamill, M. M., & Ghanem, K. G. (2022). Diagnosis and treatment of sexually transmitted infections: a review. Jama, 327(2), 161-172.
Bhatia, S., Gupta, R., & Yadav, S. (2022). Herpes, Gonorrhea, Chlamydia, and HPV Infection. In Infections and Pregnancy (pp. 265-283). Springer, Singapore.