Topic: Respiratory System: Selected Pathophysiology and Pharmacologic Therapy
Interview a client with a chronic pulmonary health condition who is on at least 2 medications.
In a 1,350-1,600-word paper, discuss the following:
1) Obtain a complete health history.
2) Obtain a complete medication history, including prescription and over-the-counter drugs or supplements.
3) Analyze the client’s current knowledge level of medications and compliance with the prescribed dosing and administration.
4) For each medication, identify the pharmacokinetics, pharmacodynamics, dose, route of administration, side effects, adverse reactions, any drug interactions, potential safety issues, and the impact on the client’s health status.
5) Formulate possible interventions related to lack of drug efficacy, lack of client knowledge, or client compliance issues as identified during the interview.
6) References three at least
Prepare this assignment according to the APA guidelines.
Interview with a Bronchitis Patient
Bronchitis is one of the chronic pulmonary health conditions. It is classified under the chronic obstructive pulmonary diseases (COPD). Patients suffering from chronic bronchitis are put under constant medication. Being a chronic ailment, it means that it has no cure. The medication that patients are given are only meant to suppress the symptoms and the sever effects. Although there are various causes of chronic bronchitis, patients suffering from the condition tend to have a complicated health history. In this discussion, patient suffering from chronic bronchitis is interviewed. Among the issues discussed are the medical history of the patient and the medication history of the patient. The discussion will further focus on the level of knowledge that the patient have in relation to the medication administered.
Rael is a 32 year female who was diagnosed with chronic bronchitis three years. She is a mother of two, married for ten years and has a supportive family. More often, patients who suffer from acute or chronic bronchitis are likely to have suffered from other respiratory ailments. Rael confirms that she used to suffer from common cold and flu right from time to time she was child. She was always in and out of hospital because of common cold. Most of her friends back in school would watch the cold and flu and after a few days, the symptoms would disappear. Yet for her, the cold would always be so hard on her that she had to be hospitalized often. Her parents did not take her condition seriously as they thought that perhaps it was her immune system that was weak. Her cold and flu would last for many days and would often recur shortly after disappearing.
At the age of twelve years, Rael developed a rare condition that would see cough hysterically even without having the common cold. Later on she was found to have symptoms of tuberculosis. Tuberculosis is an airborne disease and Rael believes that she could have contracted the disease when playing school. Luckily, she was treated and cured for the ailment. Unfortunately however, it was discovered that the tuberculosis had stayed in her body for a long time without detection. This led to a constant reoccurrence even after she had been declared free from the ailment. It is while being treated from tuberculosis that it was found that her lungs had been infected and that she was already suffering from chronic bronchitis.
As a teenager, Rael also confesses to have engaged in cigarette smoking as part of the adventurous discovery among young people. This is a likelihood that could have contributed to her condition. The nicotine contained in the tobacco that makes up the cigarettes is known to have serious adverse effects on the lungs. Further, Rael took up a first job at an industry that was producing a lot of smoke. The specific department where she was working, she was exposed to dust and smoke. She constantly inhaled dust and smoke for twelve hours which was the duration of her shift. She worked in that environment for two years.
The next job Rael took up was in the hospitality industry. She was working in a cold room which was basically room full of freezers. More often, Rael did not have proper protective gear such as warm clothing. This means that her lungs weird constantly exposed to extremely cold conditions. All these factors are believed to have played contributory role on her developing chronic bronchitis.
Due to the various respiratory problems that Rael has had in her life, she has been under constant medication. Upon diagnosis that she was suffering from chronic bronchitis, she was put under strong medication and vaccines meant to suppress the condition. A chronic must be constantly be suppressed as it has jot cure. Without the suppression of the symptoms, the illness tends to weaken the immune system of the body leading to early deaths (Susan, 2005). When she was found to be suffering from the disease, Rael was advised to quit smoking. Although it took her time to completely stop because she was already addicted, she eventually managed to stop. This helped to reduce the risk of the disease spreading into her body and eating into her immune system.
In addition, Rael was put under two main forms of medication namely Seretide and Ventolin. Both drugs fall under the bronchodilators class of drugs. These are drugs that are used to treat respiratory ailments. With administration of the drugs, the symptoms of chronic bronchitis can now be controlled. Rael was first given oral medication and when she responded positively, she was put under inhalers. The two medicines aforementioned are therefore in form of inhalers. There are people who react negatively with certain respiratory drugs. In case of such a reaction, a patient will be given advice by a doctor on the next step to take (Sommers, 2010). Depending on the nature of the case, some patients suffering from chronic bronchitis may in addition to these drugs be put on antibiotics. Rael used antibiotics for a short period of time. When her health improved, the doctor discontinued use of antibiotics.
Physiotherapy of the chest is another form of treatment that Rael has been undergoing. This is mainly used for purposes of ensuring that the airwaves are not clogged. People suffering from respiratory ailments often encounter difficulties in breathing. This is because most of the times the airwaves are blocked by some secretions from the lungs. Physiotherapy is therefore crucial in ensuring that nay secretions released are cleared off from the airwaves.
Oxygen therapy has also been identified as yet another effective form of treatment for patients with respiratory problems (Susan, 2005). This is a therapy that targets patients who are completely unable to breath. When the airwaves have been blocked completely and physiotherapy has no impact, then patients must be given oxygen through masks. This is to ensure that despite in inability of the patient to breathe normally, they are still able to have sufficient fresh air.
Patient’s knowledge of Medication
Rael admits that even having used the medication for a period of three years, she still does not have much knowledge about the drugs. Besides knowing that they help control the symptoms of the ailment, she does not know anything more. Majority of patients have complete trust in the doctors’ prescriptions that they do not bother to even read the writings that appear on the packet of the drugs. This ignorance could be costly for the patient. This is because, errors may happen at the prescription level and if the patient is not keen enough to read through, they results could be fatal (Sommers, 2010). However, even without the proper knowledge on the drugs that she has been taking Rael has been keen on the compliance of the dotage. She has not missed a single dosage because she understands the complications that may arise should that happen.
Details of each medication
Pharmacokinetic refers to the manner in which drugs are absorbed into the body and the manner in which the body makes use of them. Seretide is taken through inhalation. It is inhaled through the nose, goes through the threats, into the bronchi and into the lungs. It follows the same channel that oxygen is inhaled into the body. Unlike oxygen however, this drug does not circulate in other parts of the body. It only circulates in the lungs. It has the effect of quelling the strong symptoms of chronic bronchitis. Incase patient experiences chest pains, inhalation of this drug reduces the pain. The effect that the drug has on the body is what is known as the pharmacodynamics of the drug (Sommers, 2010). This drug has not been found to have any negative effects on the body of patient. Rael has been using the drug from more than three years and she has not experienced any side effects. It is however crucial to seek medical assistance before taking other drugs for other ailments. In some cases, drugs of different ailments tend to clash because of the different chemical components.
Just like Seretide, Ventolin is absorbed into the body through inhalation. This drug however is available in other forms including liquid and tablets. Patients use their most preferred method. When taken, the drug is absorbed into the blood stream. The blood then goes to the heart and then to the lungs (Siafakas, 2012). The lungs absorb only the required contents of the drug while releasing the rest as waste. In terms of pharmacodynamics Ventolin has the effect of unblocking any pipes of the lungs that may be blocked. It also reduces the secretion of mucus or any other substances that has the effect of causing blockage. The drug has been said to cause drowsiness among some patients. Rael says that she would experience drowsy spells when she began using the drug. With time however, the adverse effects appear to diminish and the patient no longer feels the adverse effects.
It is crucial for medical practitioners to create awareness among patients on the importance and effect of a drug. There is general ignorance that majority of patients display as far as drug usage is concerned. Patients must go beyond the following what the doctor says. In addition, they should also take initiative to read what appears on the packet. This helps to detect among other things, expiration date of the drug and wrong prescriptions (Rakel, 2011). Although Rael has been disciplined and complied with dosages, there are patients who are known not to comply with the dosages. This is common among patients experiencing pain who tend to overdose in an attempt to get rid of the pain immediately. Doctors must ensure that they take patients through the importance of sticking by the rules given. Patients should not contradict the prescriptions of the doctor and should also avoid buying over the counter medication. Over the counter medication poses a huge threat to the health of patient as they may counter the positive effect of the proper drug.
Rakel, D. (2011). Textbook of family medicine. New York: Elsevier Health Sciences.
Siafakas, N. M. (2012). Management of chronic obstructive pulmonary disease. London: Sage
Sommers, M. (2010). Diseases and disorders: a nursing therapeutics manual. London: F.A. Davis.
Susan, L. (2005). Handbook of clinical health psychology. New Jersey: John Wiley and Sons