AL a 46-year-old female presents to clinic with chief complaint, “I get short of breath and wheeze almost every night. I also have a cough that wakes me up 2-3 times a week.” Her symptoms have been present almost 3 months. She has no prior

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WEEK 4 ASSIGNMENT (covers weeks 3-6) 

SCENARIO 1 

What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)? 

• Ubrelvy 200 mg PO at onset of migraine #30 0 RF 
• memantine/donepezil (Sinemet) 7/10 mg po once daily #30 1 RF 
• Stalevo 200 mg po TID #90 2 RF 
• levothyroxine 137 mg PO daily #30 3 RF 
• omeprazole (Protonix) 40 mg PO daily before breakfast #30 3 RF 

 SCENARIO 2 

AL a 46-year-old female presents to clinic with chief complaint, “I get short of breath and wheeze almost every night. I also have a cough that wakes me up 2-3 times a week.” Her symptoms have been present almost 3 months. She has no prior hospitalizations or ED visits; no smoking history and no significant occupational exposures. She takes cetirizine for seasonal allergic rhinitis. NKDA. CBC normal, BP 114/68, HR 88, RR 18, SpO₂: 97%, spirometry: FEV₁ 70% predicted, FEV₁/FVC 0.65, reversibility testing: FEV₁ improves by 15% after albuterol inhalation, Peak Expiratory Flow (PEF): 65% of personal best. What is your diagnosis and treatment plan? How would you monitor treatment and what patient education would you provide? 

 SCENARIO 3 

LV is a 9-year-old female that experiences brief staring episodes lasting ~10 seconds, occurring multiple times per day. Otherwise healthy, NKDA. Normal CBC, CMP, LFTs. She has been diagnosed with typical absence seizures. As her provider, your task is to initiate pharmacologic therapy. Write a complete medication order for LV, include monitoring parameters and patient/caregiver education points relevant to the medication and seizure management. 

 SCENARIO 4 

TY is a 65-year-old male with poorly controlled type 2 diabetes and exhibits challenges with adherence. Current medications include donepezil 5 mg po qhs and losartan 50 mg po daily. His lab work today includes: BG 190 mg/dL, A1C  8.5%, K⁺ 4.1,  Cr 1.9, eGRF 26, BP 125/76. 

Which of the following would you prescribe: 

• canagliflozin (Invokana) 100 mg PO daily 
• exenatide (Byetta) 5 mcg SC twice daily 
• glimepiride 1 mg PO daily 
• glyburide 2.5 mg PO daily 
• metformin 500 mg PO daily  
• semaglutide (Ozempic) 0.25 mg SC once weekly  
• sitagliptin (Januvia) 50 mg PO daily 

 

What is the classification and MOA of the drug you selected? What education would you provide and how would you monitor the effectiveness of the treatment plan? What is his goal A1C and blood pressure? 

APA References for the scenarios are within past 5 years and include the appropriate clinical practice guideline if applicable.

Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

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