Is there any additional subjective or objective information you need for this client? Explain

Is there any additional subjective or objective information you need for this client? Explain.

I would ask about medications he has taken recently, and if anything has helped alleviate or make better. I would ask about any medical history whether it’s past, present, and other symptoms such as SOB or wheezing, sore throat, or earache. I would ask if he smoked.

Would you treat Mr. JDs cold? Why or why not? 

Yes, I would Treat Mr. JDs cold because he has symptoms that prolonged for 2 weeks and isn’t getting better. Based upon my interpretation it sounds like Mr. JD has a common cold which is caused by a virus. The author Reddy (2014) proclaimed that a common cold can last up to two weeks for the principal symptoms and perhaps weeks more but there’s also a possibility of secondary infections such as bacterial sinusitis. At this point symptoms may indicate acute sinusitis so I would treat him.

What would you prescribe and for how many days? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings

 I would treat Mr. JD with Augmentin. Augmentin is a generic name for Amoxicillin. Amoxicillin is a penicillin derivative used for the treatment of infections caused by gram-positive bacteria, in particular streptococcal bacteria causing upper respiratory tract infections ( Drugbank online, 2021).  The usual dose for adults is 500-mg tablet every 12 hours or one 250 mg tablet of Augmentin every 8 hours. Amoxicillin alone is indicated to treat susceptible bacterial of the ear, nose, throat, genitourinary tract, skin, skin structure, and lower respiratory tract. Amoxicillin is given with calvulanic acid to treat acute bacterial sinusitis, community acquired pneumonia, lower respiratory tract infections, acute bacterial otitis media, skin and skin structure infections, and urinary tract infections (Drugbank online, 2021). Mechanism of action: Amoxicillin competitively inhibits penicillin-binding protein 1 and other high molecular weight penicillin binding proteins (DrugBank online, 2021). Route: Taken by mouth PO on empty stomach or with food or injectionHalf-life: The half life of amoxicillin is 61.3 minutes(Drugbank online, 2021) Metabolized In:Incubation with human liver microsomes has led to the detection of 7 metabolites(Drugbank online, 2021)Eliminated Out: 125mg to 1g doses of amoxicillin are 70-78% eliminated in the urine after 6 hours(Drugbank online, 2021)Contraindications and black box warnings: Augmentin is contraindicated in patients with a history of serious hypersensitivity reactions (e.g., anaphylaxis or Stevens-Johnson syndrome) to amoxicillin, clavulanate or to other beta lactam antibacterial drugs (e.g., penicillins and cephalosporins). Augmentin should not be taken by individuals with renal impairment and liver problem (Drugbank online, 2021). I would recommend an OTC decongestant to help suppress cough and alleviate symptoms and Ibuprofen. I would prescribe patient to take Augmentin for 14 days for bacterial sinusitis.

Would this treatment vary if Mr. JD was a 10 year-old 78 lb child? Include the class of the medication, mechanism of action, dosing, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings 

Amoxicillin (Augmentin) would be the first choice of therapy for sinusitis in children. For children the doses are determined by the age and pounds of the child as well as the indication for medication. The usual dose is 20 to 40 milligrams per kilogram (kg) of body weight per day, divided and given every 8 hours, or 25 to 45 mg per kg of body weight per day, divided and given every 12 hours (“Medscape,” 2019, p. 5). The class of drug is penicillin (Amoxicillin) is the first choice for non-penicillin allergic patients including children. Amoxicillin similar bactericidal action as penicillin. It acts on susceptible bacteria during multiplication stage by inhibiting cell wall mucopeptide biosynthesis. The medication is metabolized in the liver and excreted through urine. The half life of Amoxicillin in children is 61.3 mins. About 5 to 10 percent of children taking amoxicillin or Augmentin will develop a skin rash at some point during the course of the medication. Most of these are non-allergic, and most are caused by viruses (Texas children hospital, 2021)

What health maintenance or preventive education is important for this client based on your choice medication/treatment?

Nonprescription management includes decongestants, either topical or systemic, to improve nasal obstruction. Mr. JD should be warned against long-term use of topical decongestants, but they can be very helpful in providing symptomatic relief during the few days it takes to respond to antibiotics. Saline nasal spray or wash prevents crusting of secretions in the nasal cavity, facilitating removal of secretions. Increase fluid intake to help liquefy secretions. The facial pain and headache associated with sinusitis can be severe, and the patient should be encouraged to take acetaminophen or ibuprofen for pain. A warm pack to the frontal and maxillary sinuses often provides pain relief, humidifier air at night, can alleviate the dry mouth caused by mouth breathing during sleep. Delivery of warmed, humidified air via nasal high flow therapy could potentially reduce replication of temperature-sensitive viruses in the upper respiratory tract ( Bibby et al, 2016). 

Bibby S., Reddy S., Cripps T., Mckinstry S., Weatherall M., Beasley R., & Pilcher J., (2016) Tolerability of nasal delivery of humidified and warmed air at different temperatures: A randomized double-blind pilot study. Medicine. 2016, 7. 

DrugBank online(2021) Amoxicillin. September 2, 2021. 

Reddy S., ( 2014) Sick again? Why some colds won’t go away. September 2, 2021. 

Texas Children’s Hospital(2021) Rashes from amoxicillin:Is it a true allergy? September 3, 2021.

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