UTI, Crohns Disease Pharmacology

Case Study:

Mrs. Tripp is a 66-year old woman with a chief complaint of generalized feeling poor and a 24-hour history of dysuria, urinary frequency, and urgency. She has had recent sexual activity. She has a 5-year history of chronic diarrhea (6 stools per day without blood), abdominal pain and difficulty maintaining weight, which seems to be getting worse. She had a hysterectomy 3 years ago. Her medications include: Sulfasalazine 500 mg. bid; calcium carbonate 1,000 mg. qd.

Most recent pertinent labs: CRP of 5 mg/L; K+ of 2.8 mg/dl; all others are WNL. Urinalysis has WBC 10-15 cells/hpf; RBC, 1-5 cells/hpf; bacteria 2-5/hpf;  nitrite negative. NKDA Physical shows an alert woman, with P=90, BP100/66, R=18, T-(oral)=99. Only abnormal findings are low weight for 5’5” woman at 100 lb, pain to palpation in upper and lower quadrants of the abdomen.

Diagnosis: Acute uncomplicated urinary tract infection. Progressive Crohn’s disease.

In a 3-5 page APA paper, respond to the following questions.

• What specific goals do you have for Mrs. Tripp’s current condition(s)?
• What therapies would you prescribe? Why?
• What current drugs might need adjustment? Why?
• What are the parameters for monitoring success of the treatment plan(s)?
• Discuss specific patient education based on treatment plan?
• If you were to use ciprofloxacin, what are the drug-drug or drug-food interactions that are of concern for this patient?
• If you were to use sulfamethoxazole-trimethoprim, what are any concerns you might have with this patient?
• What are the over-the-counter medications/therapies that would be useful for this patient’s health issues?
• What dietary and lifestyle changes should be recommended for Mrs. Tripp?
• Based on your treatment, what side effects are you asking Mrs. Tripp to watch for as a precaution to seeking additional medical care?

Additional page

Review information you find on the Colorado PDMP program and be prepared to discuss the quad registry in Colorado. How you would design your opioid prescribing practice if you had one. Why is there a rising epidemic of prescribing opioids? In the world of musculoskeletal injury or pain, what are some effective treatments that are not opioids? When are anti-inflammatory or muscle relaxants useful? What role does genetic research play in prescribing pain medications?