Nurs 5334 Otitis Media Case Study.

NURS 5334 OTITIS MEDIA CASE STUDY. Running head: OTITIS MEDIA CASE STUDY 1 Otitis Media Case Study Sally Chambless The University of Texas at Arlington College of Nursing and Health Innovation In partial fulfillment of the requirements of Advanced Pharmacology (NURS 5334) Mary Davis, DNP, MSN, ANP-BC, ADM-BC May 26, 2018 NURS 5334 OTITIS MEDIA CASE STUDY OTITIS MEDIA CASE STUDY 2 • Recommended Drugs: List three recommended drugs (list one of each: Antibiotic, pain med and med for fever) as indicated for this diagnosis • Drug Categories and Subcategories: Identify the category of each recommended drug • Choose antibiotic from the above three recommended drugs to treat identified disease • Rationale Provide rationale, clinical guidelines, or evidence for the antibiotic selected as drug of choice 5334 CASE SUMMARY TABLE • Fever of 39.5 ֯C for greater than 24 hours (Burcham & Rosenthal, 2019, p. 1306). • Erythematous right tympanic membrane (TM), bulging TM with limited mobility, and purulent fluid behind TM (Burcham & Rosenthal, 2019, p. 1304). • Antibiotic: Amoxicillin-clavulanate (Burcham & Rosenthal, 2019, p. 1306). • Ibuprofen: Pain reducer (Burcham & Rosenthal, 2019, p. 1307). • Acetaminophen: Fever reducer (Burcham & Rosenthal, 2019, p. 1306). 1. Amoxicillin-clavulanate Category: Anti-infective (Lexicomp, 2017, p. 127) Subcategory: Aminopenicillins (Lexicomp, 2017, p. 127) 2. Ibuprofen Category: Nonopioid analgesic (Lexicomp, 2017, p. 1132) Subcategory: Nonsteroidal Anti-inflammatory Drug (NSAID) (Lexicomp, 2017, p. 1132) 3. Acetaminophen Category: Antipyretic (Lexicomp, 2017, p. 50) Subcategory: Analgesic (Lexicomp, 2017, p. 50) • Amoxicillin-clavulanate (Augmentin) • Symptoms: List two pertinent signs and symptoms or risk factors OTITIS MEDIA CASE STUDY 3 • Contraindications and or Risks, as appropriate: Identify contraindications and risks as appropriate The patient should be treated with amoxicillin-clavulanate based upon the history of chronic otitis media infections and current severe otitis media (AOM) infection. Patient has had three previous AOM infections with the most recent infection only two weeks prior treated with high dose amoxicillin. The recurrent AOM infections in conjunction with the recent upper respiratory infection, indicates the patient exposure, and likely infection, with M. catarrhalis or S. pneumoniae, which can be resistant to amoxicillin, or H. influenzae, which produces beta-lactamase and inactivates amoxicillin (Burcham & Rosenthal, 2019, p. 1307). Therefore, the preferred treatment would be amoxicillin-clavulanate because the clavulanic acid will impede beta-lactamase (Burcham & Rosenthal, 2019, p. 1307). The present clinical guidelines indicate treatment with amoxicillin-clavulanate if a patient has been treated with amoxicillin for AOM within the past 30 days and presents with severe subsequent illness (Lexicomp, 2017, p. 129).