A 64-year old female presents with increased stiffness and...

A 64-year old female presents with increased stiffness and...

Author: brecht 2017

A 64-year old female presents with increased stiffness and pain in the joints of her hands. She is a retired factory worker


A 64-year old female presents with increased stiffness and pain in the joints of her hands.  She is a retired factory worker, previous smoker and has been overweight most of her adult life. What might be 4-5 different differential diagnoses? Build your case in a manner that you could manage this patient pharmacologically.
Evaluate the APN role for independent and interprofessional collaborative management of pharmacological agents in prescribing and monitoring pharmacologic therapies in patients across the lifespan 
Differentiate evidence-based practice guidelines in management of therapeutic agents for selected system problems. 
Analyze major pharmacological groups including pharmacodynamics, pharmacokinetics, and indications for use, in the management of patients in primary care and with specific individuals. 
Distinguish internal and external environment factors affecting drug action, reaction, efficacy, and interaction. (PO 1)
You diagnose your patient with osteoarthritis after performing a history and physical. Pertinent findings included Bouchard’s and Heberden’s nodes. No additional work up was needed. The client had previously taken aspirin for her symptoms that she described as helpful but much like the Naproxen prescribed by you caused her GI distress. What are other Pharmacologic treatment options at this point and explain the rationale, molecular mechanism of action of drugs and major adverse effects (discuss kinetics & dynamics).
You make the decision to start her on celecoxib (Celebrex) 100 mg twice daily. Celecoxib is a non-narcotic, cyclooxygenase-2 (COX-2) inhibitor. How does celecoxib differ from naproxen and what might you do prior to starting celecoxib and why?

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