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Analysis of client case reports: Benefits and risks of drug use


 Purpose: The analysis of client case reports provides an opportunity to reflect and critically/scientifically analyse a pharmacological intervention provided in the clinical environment to a specific client. Learning outcome/s being assessed: 1, 2, 3, 4, 5 Task: No drug is safe. Therefore the benefits of a drug should outweigh the risks associated with its use. In this assessment, you are required to write a report analysing the benefit/risks of a specific drug and its PK/PD parameters prescribed at a specific point in time/presentation in a fully anonymous client case chosen from your clinical practice. The case analysis in this assignment is retrospective so it does assume that a drug has been prescribed in order for it to analysed in the context of a specific patient/client. The report is intended to be written at a level appropriate to your peers and other medical/health professionals. Instructions: Important: See the requirements for written Assignments (i.e. information on formatting, submission etc). Your report should be one (1) document and consist of: A separate title page (1 page) Your case report: use clearly titled section headings A separate reference page(s) This Assignment is a report (not an essay), so you can include aspects such as a brief Abstract (on the title page), headings/subheadings, clearly explained diagrams, tables, bullet points, appendix (if necessary). The content of the report should include the following: Background: What drug(s) will be analysed in the body of the report? Why do you think this case is important? what is the issue? why you chose to write it up? - Provide a clear and concise rationale that explains the issue/background/choice Case Description: Include a brief patient-specific vignette (300 words) of information that is relevant to the prescription of the drug(s) at the point in time of the client presentation A brief description/history of the presentation (only include essential relevant medical/social/family history) Report the diagnosis/differential diagnosis that justifies the use of the drug that is the focus of the report (do not spend time justifying/explaining the diagnosis) Key symptoms/examinations/investigations relevant to the drug prescribed (include reference ranges where relevant e.g. Laboratory tests) Include a table of all the client's current medications, dose, frequency etc. Remember to include complementary and over the counter medicines. Case Analysis: Using headings/subheadings, include the following in your analysis: Identify/explain and focus on the relevant physiology/pathophysiology/pathogenesis that underpins the pharmacological issue in the context of the client. Be sure to identify/analyse and link the key aspects that are most relevant/pertinent to how the drug(s) restore or manage (patho)physiologic function and provides context to the drug's mechanism of action. Choose 1 (or 2) key drugs relevant to the pharmacological issue used in the treatment of this client. (Note: there may situations where it is logical to analyse more than 2 drugs e.g. triple therapy H. pylori, in which case it would be sensible to do so). For each drug: Discuss the mechanism of action. Concisely/precisely report evidence of efficacy and incidence (rates) of side effects from empirical scientific literature (e.g. RCT's, meta-analysis or observation/pragmatic studies if necessary). In the context of the client explain/discuss the pharmacokinetics. Be thorough and specific using reputable peer-reviewed academic literature and other reputable resources. Discuss the possible side/adverse effects of this drug, relevant drug-drug interactions, contraindications, and client considerations that require attention/monitoring in this client and explain why. Pay particular attention to the side/adverse effects for which the client is at increased risk or may potentially be serious. The mechanisms (e.g. PK/PD) by which these interactions, side/adverse effects occur should be identified and explained. Use reputable peer-reviewed academic literature and other reputable resources. Critical analysis and reasoning should be evident in reporting Use the non-proprietary (non-commercial) names for the drugs Outcome and Follow-Up/Prescriber considerations: Describe the client's response to the pharmacological interventions and actual follow-up received. If this is unknown, discuss the follow-up that might reasonably be expected to have occurred. Discuss prescriber considerations and relevant client advice/education. Explain rationales for your recommendations. Conclusion: Based on an objective critical synthesis of the pharmacological analysis, conclude with a discussion of what was done well and what (if anything) could be improved along with any recommendations/implications you may have identified for practice. Take-Home Messages: In 3 to 5 bullet points summarise the key points you have learned from analysing this client case. References: Use your textbook, reputable peer-reviewed academic literature, and other highly reputable resources (e.g. NZ Formulary, Medsafe, Bpacnz, UptoDate, Martindale).

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