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Clinical Assignment

1730 words - 7 pages

Danielle Wilkinson
Alternate Clinical Assignment
01/27/2014
Case Study #1
Episode I

1. List five common environmental triggers for asthma and give at least one specific example for each.

Five common environmental triggers for asthma are exercise, allergens, odors, weather, and food. Exercise induced asthma is common in young children and adolescents. The airways in the lungs become narrowed during strenuous exercise. There are many different types of allergens that induce asthma like dust mites, pollen from tress, mold, and pet dander. Odors that can trigger asthma are cigarette smoke, some kinds of perfume, cleaning products, and smoke from burning wood. Weather can trigger ...view middle of the document...

The increased levels of cAMP activates kinases, which inhibit the phosphorylation of myosin and decrease intracellular calcium which all result in bronchodilation. Fluticasone acts as an anti-inflammatory and immune modifier. To treat serious asthma symptoms, albuterol is more commonly used because it is a quick relief, rescue drug while fluticasone is a corticosteroid used in maintenance for asthma. The fluticasone medication will prevent asthma symptoms because it is used as a controller.

Episode II –

4. How is prednisone different from fluticasone? Is there more of a risk of side effects with prednisone? Why or why not?

Prednisone has different side effects from fluticasone. Prednisone may cause depression, euphoria, personality changes, psychoses, and restlessness. Fluticasone may cause headache, dizziness, cough, and muscle pain but does not affect any mood changes or personality. Prednisone has more increased risk of side effects than fluticasone because the chances of adverse reactions are greater in prednisone.

5. Could the behavioral problems that Leia experienced be the result of the oral steroid? Briefly describe any evidence for this, including how dosage might factor into the incidence of side effects.

Yes the behavioral problems that Leia experienced can be the result of the oral steroid because personality changes is one of the side effects. An increase in dosage may highly factor into risk of side effects especially if the patient has never taken the medication before.

6. Besides Leia’s mother possibly giving the wrong dose to Leia, what other types of mistakes could cause Leia to get too much of this medication?

Prednisone peaks in about 1-2 hours and stays in the system for 1.25-1.5 days. If Leia is taking the drug once every morning, some of the previous day’s dose is already in her system. Leia may also not be taking the drug with meals. Food in her stomach may absorb some of the medication, if she’s eating it on an empty stomach she may have an increase in the risk of side effects.

Episode III

7. What type(s) of bacterial pathogens commonly cause community acquired pneumonia in the U.S.? Make sure to include the full genus and species names, including the name for the pathogen that causes “walking pneumonia.”

Streptococcus pneumoniae is the causative agent for community acquired pneumonia. Other agents that may cause pneumonia are Haemophilus influenza, Staphylococcus aureus, Legionella spp, and viruses. Patients that have “walking pneumonia” only experience mild symptoms of pneumonia. The causative agent that causes “walking pneumonia” is Mycoplasma pneumonia.

8. Which of these pathogens should we worry the most about in Leia’s particular circumstance? Explain your answer.

We should worry about the agents that cause community acquired pneumonia because Leia went back to school where other children can be spreading germs. Leia is young so she’s probably not washing her...

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