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)?

· metaprolol succinate ER 50 mg PO daily #30 1 RF

· amiodarone 75 mg PO daily #30 1 RF

· amlodipine/hydrochlorothiazide (Lotrel) 5 mg/12.5 mg PO daily #30 3RF

· hydralazine/isosorbide mononitrate (BiDil) 37.5 mg/20 mg PO every 8 hours #90 1 RF

· clonidine patch (Catapres-TTS-1) 0.1 mg/day apply one patch to skin and replace every 3 days #10 patches 0 RF

SCENARIO 2

Does verapamil have a high or low first pass effect? Please discuss why this is important to know and how it relates to bioavailability. Define these two terms. What route has 100% bioavailability? In addition to parenterally, how can verapamil be given to counter the first pass effect? Write a sample prescription for this medication.

SCENARIO 3

Where are the majority of cytochrome P450 (CYP) enzymes located? Using the Medscape pill identifier, enter the following characteristics to identify the medication AND strength. What CYP enzyme metabolizes this medication? How can this information be applied to medication therapy management? Write a sample prescription for the identified medication and strength. What are goal cholesterol levels and (Coronary Artery Disease) CAD risk factors?

Imprint (ATO 40) Shape (Oval) Color (White) Form (Tablet) Scoring (None)

SCENARIO 4

RT is a 54-year-old female presenting with blood pressure today of 135/90 HR 80 RR 15. Her last visit to the clinic 3 months ago shows a BP of 134/88. She is currently taking metformin 500 mg PO BID with meals, ibuprofen 600 mg PO TID for back pain, and duloxetine 60 mg PO daily. What is her goal blood pressure? What medication would you prescribe and how would you improve her treatment (include complete medication order)? What patient monitoring and education would you provide?

Note on Assignment Attempts 

Students are expected to review their work and submissions of work carefully prior to due dates. Unless otherwise approved by the faculty, students are allowed one submission of graded work per assignment. While the classroom allows for multiple submissions, once an assignment is graded, submissions will no longer be accepted unless approved by the faculty. If an assignment is submitted prior to the assignment deadline and has not yet been graded, then students may submit a revised assignment prior to the assignment deadline. Once the deadline has passed, resubmission is not permitted.