A 60-year-old White woman with newly diagnosed peptic ulcer disease, generalized anxiety disorder, and iron deficiency anemia. She also has a long history of asthma and depression. She is a strong believer of herbal medicine. She takes St. John’s wort for her depression, iron pills for her anemia, and alprazolam (Xanax) as needed for her anxiety. During her asthma exacerbation, she is instructed to take prednisone for at least 5 days. She also takes esomeprazole (Nexium) for her peptic ulcer disease. Three months later, she experienced severe fatigue, shortness of breath, dizziness, and swelling/soreness in the tongue. Her asthma is well controlled with the occasional use of albuterol (Proventil) inhaler. During her physical exam, her physician suspected that she had bacterial vaginosis and gave her a prescription for a 1-week course of metronidazole (Flagyl). She drinks at least two to three cans of beer per day.

Diagnosis: Drug–Drug Interactions

1. 1.St. John’s wort is known to inhibit which of her medication that is known to be metabolized by cytochrome P-450 (CYP3A4) and could potentially cause her to experience significant fatigue?
2.  
3. 2.Which of her medication could interfere with the absorption of her iron pills?
4.  
5. 3.Which of her medication could potentially cause her to develop vitamin B12 deficiency?
6.  
7. 4.How does metronidazole interfere with alcohol?
8.  
9. 5.If she was given a prescription for ketoconazole, which of her medication could interfere with its absorption?

Rubric

Provides clear examples supported by course content and references. Cites three or more references, using at least one new scholarly resource that was not provided in the course materials. All instruction requirements noted.

Initial post and peer post(s) made on multiple separate days. All instruction requirements noted.

Well-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

PLEASE SEND TO WRITER 584. FROM PAT

A 60-year-old White woman with newly diagnosed peptic ulcer disease, generalized anxiety disorder, and iron deficiency anemia. She also has a long history of asthma and depression. She is a strong believer of herbal medicine. She takes St. John’s wort for her depression, iron pills for her anemia, and alprazolam (Xanax) as needed for her anxiety. During her asthma exacerbation, she is instructed to take prednisone for at least 5 days. She also takes esomeprazole (Nexium) for her peptic ulcer disease. Three months later, she experienced severe fatigue, shortness of breath, dizziness, and swelling/soreness in the tongue. Her asthma is well controlled with the occasional use of albuterol (Proventil) inhaler. During her physical exam, her physician suspected that she had bacterial vaginosis and gave her a prescription for a 1-week course of metronidazole (Flagyl). She drinks at least two to three cans of beer per day.

Diagnosis: Drug–Drug Interactions

1. 1.St. John’s wort is known to inhibit which of her medication that is known to be metabolized by cytochrome P-450 (CYP3A4) and could potentially cause her to experience significant fatigue?
2.  
3. 2.Which of her medication could interfere with the absorption of her iron pills?
4.  
5. 3.Which of her medication could potentially cause her to develop vitamin B12 deficiency?
6.  
7. 4.How does metronidazole interfere with alcohol?
8.  
9. 5.If she was given a prescription for ketoconazole, which of her medication could interfere with its absorption?

Rubric

Provides clear examples supported by course content and references. Cites three or more references, using at least one new scholarly resource that was not provided in the course materials. All instruction requirements noted.

Initial post and peer post(s) made on multiple separate days. All instruction requirements noted.

Well-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

PLEASE SEND TO WRITER 584. FROM PAT