Subjective:
KK is a 28-year-old patient coming into the physician’s office for their yearly asthma check-up. KK is frustrated because recently their asthma symptoms have begun to interfere with their work and they don’t feel like their inhaler use is helping them. In fact, recently, KK noticed a black substance in their mouth – which they believe is from inhaling harsh chemicals from their inhaler.
KK works full time in a bakery and has really good health insurance.
Objective:
Medication List:
Loratadine 10mg QD
Omeprazole 200 mg QD thirty minutes prior to breakfast
Pepto-Bismol PRN for GERD symptoms
Escitalopram 10 mg QD
Multivitamin 1 tablet QD
Advair HFA ® 100mcg/50mcg PRN for asthma symptoms
Physical Presentation/Vitals:
5ft 10 in; 148lb; Pulse: 90 bpm; RR: 11 bpm; O2: 98%; BP: 128/82 mmHg
Past Medical History:
You are waiting for the patient’s medical history from a different physician’s office.
Initial Post – Prompts:
1. Identify ONE potential trigger that exists for KK’s asthma
Describe in biologic/pharmacologic terms how this trigger may lead to asthma exacerbation/symptoms
2. Advair contains two different medications
Identify both, describe the mechanism of action, and describe what chemical characteristics these compounds have to improve/modify their activity/effectiveness (compared to other compounds)
Hint: specifically, compare this compound to others in the same class
3. While KK is here in the office, waiting on their medical history, identify any adjustments you would like to make to their medication/treatment. Be specific and complete in your recommendations.
Hint: What errors do you see? Anything missing?