Kiara is a 53-year-old female with severe chronic persistent asthma. She also has a history of…

In: Nursing

Kiara is a 53-year-old female with severe chronic persistent asthma. She also has a history of…

 

 

Kiara is a 53-year-old female with severe chronic persistent asthma. She also has a history of osteoporosis, diabetes, and hypertension. Her daily treatment regimen for the control of her asthma is comprised of high-dose inhaled beclomethasone, inhaled salmeterol, slow-release theophylline, and monteleukast. She has complained to her specialist that she is still having frequent exacerbations and night-time symptoms. He then decides to put her on a short course of oral prednisone for 14 days.

a. How would prescribing additional glucocorticosteriods such as prednisone help in the treatment of the major symptoms of asthma? State two of these symptoms and the mechanism by which prednisone will treat them.

b. Considering her medical history, which factors should be taken into consideration by her specialist before prescribing oral prednisone? Substantiate your answer by referring to the mechanism by which prednisone would aggravate these conditions.

c. After two weeks of frequent asthma attacks, Kiara decides to double the dose of her theophylline. Comment on the appropriateness of her decision to double the dosage, and discuss the implications thereof. Justify your answer.

d. Which drug class should be used if she experiences an asthma attack? Justify your answer.

e. Following a thorough investigation, Kiara’s specialist establishes that her exacerbations are most likely due to improper inhaler technique. Too much of the drug is deposited in her mouth and as a result is not reaching the lungs. What can be done to overcome this issue? Justify your answer.

f. If Kiara had hepatic dysfunction, what would the implication be of prescribing the short course of oral prednisone? Justify your answer.

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