Treatment of Strep Throat case study

Treatment of Strep Throat Submitted by Shannon Delite Leake The University of Texas at Arlington College of Nursing In partial fulfillment of the requirements of Advanced Pharmacology N5334 Mary Davis, DNP, MSN, RN, APN-BC, CRNP, ADM-BC September 29, 2017 1 Treatment of Strep Throat Treatment of Strep Throat CASE SUMMARY: A 5-year-old boy presents with complaints of sore, throat, stomachache, and headache. Mom reports he has been sleeping more than usual and as not eaten solid food for two days. Physical examination reveals patient is obviously fatigued with elevated temperature of 38.8C (101.8F), swollen uvula, reddened tonsils with white exudate, soft palate is tender with petechia noted, anterior cervical lymph nodes are noted to be enlarged. Rapid Strep test is positive for strep. 5334 CASE SUMMARY TABLE 1. Symptoms: List two pertinent signs and symptoms Sleeping more than usual for two days No solid food in two days Complains of headache Complains of stomachache Sore throat 2. Recommended Drugs: **Drug of choice – list at least 3 recommended drugs List recommended drugs as indicated for this diagnosis    Penicillin V 250mg two times a day for 10 days (.Chahine, Chamoun, 2 Treatment of Strep Throat & Sucher).  Amoxicillin 50mg/kg one time a day for five to 10 days (Chahine, Chamoun, & Sucher).  Amoxicillin 25mg/kg two times a day for 10 days (Chahine, Chamoun, & Sucher).  Azithromycin (Zithromax) 12mg/kg daily for five days (Chahine, Chamoun, & Sucher) .  Advil (Ibuprofen) (Vallerand, Deglin, & Sanoski, 2017). 3. Drug Categories and Subcategories: Identify the category of each recommended drug.  Penicillin V is classified therapeutically as an anti-infective and pharmacologically as penicillin. It is categorized as a pregnancy category b medication (Vallerand, Deglin, & Sanoski, 2017).  Amoxicillin is classified therapeutically as an anti-infective and anti-ulcer treatment and pharmacologically as an aminopenicillin. It is categorized as a pregnancy category B drug (Vallerand, Deglin, & Sanoski, 2017).  Azithromycin (Zithromax) is therapeutically classified as an anti-infective and as an agent for atypical mycobacterium and pharmacologically as a macrolide. It is categorized as pregnancy category b medication 3 Treatment of Strep Throat (Vallerand, Deglin, & Sanoski, 2017).  Advil (Ibuprofen) a non-steroidal anti-inflammatory medication it’s other therapeutic classifications include anti-pyretic, non-opioid analgesic, antirheumatic and pharmacologically classified as a non-opioid analgesic with is a pregnancy C drug up to the 30th week of pregnancy and a category D from 30 weeks (Vallerand, Deglin, & Sanoski, 2017). 4. Drug(s) of Choice: FOR THE MAIN DIAGNOSIS ONLY, provide the chosen drug(s) of choice for treatment. 5. Rationale: Provide rationale, clinical guidelines, or evidence for the selected drug of choice  Patient requires anti-infective treatment due to sudden onset of symptoms which include an elevated temperature, Amoxicillin 25mg/kg two times daily for 10 days will be prescribed due to it tastes better in suspension form that Penicillin  Ibuprofen should be given to reduce fever and control pain. 6. Contraindications and or Risks, as appropriate: Identify contraindications and risks as appropriate  Amoxicillin should not be given to individuals who have had an allergic reaction penicillin, a cross sensitivity has been noted with cephalosporin and other betalactams, caution should be exercised when using in renal insufficiency, infectious mononucleosis or cytomegalovirus as this increases the risk for a rash (Vallerand, Deglin, & Sanoski, 2017). 7. What Patients Must Understand: Identify at least 3 appropriate 4 Treatment of Strep Throat teaching points for the patient and/or family (HINT: 3 teaching points is rarely adequate for good patient care)  Signs and symptoms to report immediately rash, severe itching, wheezing or other signs of difficulty breathing (Vallerand, Deglin, & Sanoski, 2017).  It is important to measure all does given accurately. Use the syringe provided by the pharmacy rather than a spoon, or other household device to administer this medication. (Vallerand, Deglin, & Sanoski, 2017).  This medication may cause yeast infections, inform the office if you notice a furry coating to the child’s tongue, or reddened, inflamed genital area (Vallerand, Deglin, & Sanoski, 2017).  Report any diarrhea, loose, or foul-smelling stool as this may indicate a disruption in the body’s normal flora and as well indicate a superinfection. Do not administer an anti-diarrhea medication without consulting office first (Vallerand, Deglin, & Sanoski, 2017).  Administer with food and report back if nausea or diarrhea persist (Vallerand, Deglin, & Sanoski, 2017).  Take this medication daily as prescribed and complete all medication, take any missed doses as soon as noticed by not if close to next dose (Vallerand, Deglin, & Sanoski, 2017).  Continue giving Ibuprofen for pain and fever as directed. 8. The Prescription(s