Question

B.Y. is a 78 year-old woman that was brought to the ER of her local hospital when she developed symptoms of a stroke. Her neighbor had checked on her and found that she couldn’t speak or move her right arm. The neighbor knows B.Y. quite well and told the ambulance crew that B.Y. had stopped taking her Toprol XL a few weeks ago because it made her feel so tired. She’d stopped taking her daily aspirin because it upset her stomach. The Toprol XL was prescribed for atrial fibrillation and the aspirin to prevent clot formation from atrial fibrillation.

In the hospital, B.Y. was determined to have had a stroke and was admitted to the neuro floor for further treatment. She was started on subcutaneous heparin and an intravenous beta blocker. Because she was unable to swallow, a nasogastric tube was placed and she was started on 2 tablespoons of an antacid TID through the tube. All further medications were given by the parenteral route, including a BID medication to prevent ulcers and a QID pain reliever. She also had an order for an acetaminophen rectal suppository, 500 mg., if fever of >101 degrees developed. On her third hospital day, she developed an arrhythmia and her physician ordered lidocaine to be given intravenously immediately.

8. What conclusions about the ulcer prevention medications half-life could you reach, based of the dose frequency? 9. What kind of a drug classification is “beta blocker,” a therapeutic or pharmacological classification? 10. Was a topical medication contraindicated with this patient? 11. Which of her orders were “standing orders?” 12. Were there any STAT orders for this patient? Are/Is such an order(s) also single order(s)? 13. Which orders were routine orders? 14. Did she have any prn orders? If so, which ones were prn? 15. How many milliliters per dose of the antacid did she get through her nasogastric tube?

Answer 1

8.The half life of anti ulcer medication are roughly 7 hours to 7.45 hours.When it is given in a frequency of 12 hours it acts effectively with simultaneous administration of antacids

9.Pharmacological classification refers to drugs having same chemical structure (calcium channel blocker,beta blocker,etc.,) while therapeutic classification refers to drugs used for same types of medical conditions. (Analgesic,Antihypertensive,etc.,)

Beta blockers are classified into pharmacological type.

10.The patient could have been prescribed with topical application of Antihypertensive drugs which can release medicine at timely interval and ensure proper control of blood pressure and preventing stroke.

11.The standing orders refers yo the prescribed medicine to the patient for treatment. They are

• Antacids (2table spoon) thrice  a day
• Anti ulcer twice a day
• Pain reliever four times a day
• Acetaminophen 500mg (SOS or prn) rectally if fever >101

12.When the patient had arrhythmia on the third day Lidocaine was a stat order to be administered immediately and it was a single dose

13.Antacids,Antiulcers ,Pain reliever,subcutaneous heparin and intravenous Beta blocker

14.The pro re nata (prn ) drug was for fever .If the patient has temperature above 101 this has to be administered

15.1 table spoon =14.7ml the 2 table spoon =29.5 ml per dose has yo be given to the patient through nasi gastric tube.