Discussion: Drug Treatments for HIV/AIDS

While HIV/AIDS is still currently incurable, the prognosis for patients with this infectious disease has improved due to advancements in drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in 1992 and was told she would survive, at most, 10 more years. Despite unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis, she has witnessed tremendous improvements in HIV/AIDS treatments which have helped patients live longer with fewer side effects. While she acknowledges that these drug treatments have kept her alive, she fears that improvements in drug therapy have led to more people becoming complacent about the disease (Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in the United States is higher than it has ever been (CDC, 2012). This poses the question: Is there a relationship between drug advancements, societal complacency, and infection?

To prepare:

· Review Chapter 49 of the Arcangelo and Peterson text, as well as the Montaner et al (2014) articles in the Learning Resources.

· Reflect on whether or not the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options for HIV/AIDS.

· Consider how health care professionals can help to change perceptions and make people more aware of the realities of the disease.

· Think about strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

With these thoughts in mind:

Write

· An explanation of whether or not you think the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options.

· Then, explain how health care professionals can help to change perceptions and increase awareness of the realities of the disease. 

· Finally, describe strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Assignment

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

· Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.

· Review the scenario assigned by your Instructor for this Assignment.

· Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.

· Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.

· Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

Write a 2- to 3-page paper that addresses the following:

· Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.

· Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state ( use CA).

· Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation. 

· Explain the process of writing prescriptions, including strategies to minimize medication errors.

Scenerio is: “As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.”

Resources for references

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

• Chapter 1, “Prescriptive      Authority” (pp. 1–3)
• Chapter 2, “Rational Drug      Selection and Prescription Writing” (pp. 5–9)
• Chapter 3, “Promoting      Positive Outcomes of Drug Therapy” (pp. 11–16)
• Chapter 4,      “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 17–40)
• Chapter 5, “Adverse Drug      Reactions and Medical Errors” (pp. 41–49)
• Chapter 6, “Individual Variation in Drug      Response” (pp. 51–56)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767

American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.deadiversion.usdoj.gov/pubs/manuals/pract/index.html

This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration.

Fowler, M. D. (2015). Guide to the code of ethics for nurses with interpretive statements: Development, interpretation, and application. Silver Spring, Maryland: American Nurses Association, 2015. 

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

hi dear,

I just need to response to this assignment,

 responses should be complete paragraph  and should further the conversation using personal experience, information from the textbook or other outside sources, asking questions, and more.  Think about how your classmates answered differently or similarly to you. What did you learn from their post?  What was most surprising or interesting?  What do you agree with or disagree with? Your responses might spark some comments and feedback for one another. 

Cocaine 

1. Behavioral effects: The behavioral effects to using cocaine are hyperverbal, energetic, and alertness (National Institute on Drug Abuse, 2017). Sometimes people will even be hypersensitive to sigh, touch, and sound when under the influence of cocaine (NIH, 2017). Just like most drugs, and everyone has a slightly different experience.

2. Physiological effects: The physiological effects of cocaine use are dilated pupils, elevated body temperature, and rapid heart rate (NIH, 2017). Larger amounts of cocaine use can also increase the high. When the high is increased other physical behaviors can happen. Some of these behaviors are restlessness, irritability, anxiety, and paranoia (NIH, 2017).

3. Acute health effects: Acute health effects of cocaine are irregular heart rhythm, stomach pains, and strokes (NIH, 2017).

4. Chronic health effects:Chronic health effects of cocaine are organ damage, or even cause organ failure. Some effects are restricted blood flow in the gastrointestinal tract, ulcers, weight loss, and even malnourishment (NIH, 2017). Cocaine  can even cause cardiac issues such as inflammation of the heart muscle and aortic ruptures (NIH, 2017).

5. Combining with other drugs: Yes when you combine cocaine with other drugs is bad. There are many risk of combining drugs. One example is heroin and cocaine. Cocaine wants to use more oxygen, and the heroin causes the respiratory rate slow down (The dangers of mixing drugs).

6. What surprised me:It really surprises me that drugs are still a massive issue in the world for recreational uses. I find it interesting how some people get very addicted, some people use everyone once in a while, and how some people don’t ever touch them. Working in the medical field really opened my eyes to many different drugs. I understand how different drugs work, and what they do to the body. On a medical standpoint drugs are very interesting and amazing, but when used for personal use they do some horrific things to you.

7llLegalization of all drugs:I think that legalization of all drugs should be done. I think if we legalized all drugs that there would be a better regulations. Legalization might help get a log of the terrible mixed street drugs out, and possibly prevent some people from having massive medical issues. I understand that no matter what, drugs will still be readily available on the streets, but maybe with drugs being regulated people could get help in a better, and control the substance abuse.

8. Decriminalization of all drugs: I think decriminalization of all drugs might be a good idea for possession of small quantities of drugs. I like this idea, because I feel like our prison are very impacted, and that true criminals are not going to prison. Just because these people go to jail for possession of drugs, do not mean they stop them once they our out. I also like the idea that treatment is an options as well.

Thanks,

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

hi dear,

I just need to response to this assignment,

 responses should be complete paragraph  and should further the conversation using personal experience, information from the textbook or other outside sources, asking questions, and more.  Think about how your classmates answered differently or similarly to you. What did you learn from their post?  What was most surprising or interesting?  What do you agree with or disagree with? Your responses might spark some comments and feedback for one another. 

Substance: Hallucinogens

2.  Time Period: 1960s

3.  Attitudes

The use of psychedelic and hallucinogenic drugs during the 1960s in America was sparked by the culmination of various major world events, political attitudes, and a populous with a desire to break social norms. Characterized as the “drug renaissance” (Wesson, 2011) this movement is most notably recognized as building its foundations in the city of San Francisco, CA during the mid-sixties when thousands of people were moving to the Bay Area in search of change and new ideologies. Historically referred to as the “hippie movement”, the world saw the advent and boom of the creation and widespread recreational use of psychedelics. Although this movement evoked a massive change in social attitudes toward psychedelics, the establishment as it were, of American society and authority was openly in opposition of this psychedelic drug counterculture. The mainstream media popularized hippies as rebellious youth, anti-Vietnam activists, and psychedelically crazed advocates of free love and rock and roll. America’s youth (in opposition of the mainstream media and society) flocked by the tens of thousands from all over the country to the San Francisco Bay Area to partake in the hippie movement (Wesson, 2011).

4.  Availability

During the 1960s specifically, there was a far higher rate of availability and use of psychedelics as legal and political enforcement had yet to ramp up and regulate these drugs. Today, most hallucinogens are still classified by the DEA as scheduled drugs and are therefore illegal and meticulously controlled and regulated. According to the National Institute on Drug Abuse (2016), roughly 15.4% of people ages 12 and older reported using some form of hallucinogenic drug, a small number when compared to the production and use during the 1960s (NIH, 2016).

5.  Widespread Use

Psychedelics during their height in the 1960s were most readily available as little was known about them in present-day society and therefore drug enforcement laws were scarce. First synthesized by Albert Hoffman in 1943, lysergic acid diethylamide would be the fuel that would ignite the hippie movement of the 1960s. The drug itself was manufactured by the company Hoffman worked for, Sandoz Pharmaceuticals of Switzerland. Although Sandoz let their patent expire in 1966, the drug itself was manufactured until that point and flowed into the United States (Levinthal, 2016, p.113-118). Perhaps two of the biggest key players in the domestic synthesis of LSD during the 1960s were underground chemists Tim Scully and Owsley Stanley. The two with the later inclusion of Nicholas Sand, had several underground labs in the San Francisco Bay Area and Denver, Colorado. In 1964, Owsley was given 400 micrograms of pure LSD that had been manufactured by Sandoz Pharmaceuticals. With this prized batch of pure LSD, Owsley and chemistry undergrad Melissa Cargill set out to synthesize an even purer form of the drug by the end of that year. Their combined efforts would of course be the stepping stone that would lead to the grandeur of the LSD production during the 1960s (Greenfield, 2007). Although the number of individual doses of LSD produced during this timeline is incalculable, combined estimates purport that the combined efforts of LSD producers in the United States (underground chemists, pharmaceutical companies, the CIA) alone may have produced anywhere from many hundreds of millions to potentially a billion doses of LSD (NSDUH, 2002).

6.  Groups Affected

There is little data regarding racial/group demographics of hallucinogen use during this time period seeing as a majority of the drugs themselves were in their infancy stage of social use and introduction and it was not until 1972 that the National Household Survey on Drug Abuse was formed. However, some percentages and estimates do exist. In a survey conducted by the National Household Survey on Drug Abuse (1997) it is estimated that approximately 17% of all Americans reported taking some form of hallucinogenic drug between 1960 and 1970. By the time of the first NHSDA survey conducted in 1972, at least 5% of Americans under the age of 18 had reported trying some sort of psychedelic. In terms of race, the same survey also purports that Whites used hallucinogens at the highest rates, followed by Hispanics, and then Blacks (Hunt, 1997).

7.  Regulations/Laws

Almost all known natural and synthetic hallucinogens are presently considered ‘Scheduled’ drugs by the Drug Enforcement Agency (DEA) in the United States currently (DEA, 2018). On October 24, 1968, Congress amended the Federal Food, Drug, and Cosmetic Act to include banning the use and possession of specifically lysergic acid diethylamide and any other drug (OLRC, 1968). Presently, administering and consuming psychedelics is illegal, however, the Food and Drug Administration has granted use of clinical trial psychedelic testing to a select few physicians. Dr. Michael C. Mithoefer, a psychiatrist in the department of psychiatry and behavioral sciences at the Medical University of South Carolina is one of those few physicians. Dr. Mithoefer has been researching the effects of 3,4-methylenedioxymethamphetamine (MDMA), a Schedule I class hallucinogen since 2001. In his study, Dr. Mithoefer and his team were approved and conducted a randomized, double-blind, dose-response, phase 2 clinical trial that shows promising results of MDMA’s effectiveness in the treatment of post-traumatic stress disorder and other psychotherapies (Mithoefer, 2011).

8.  What Has/Hasn’t Improved

The query of if American society as a whole improved or deteriorated in regard to the use of hallucinogenic drugs is most definitely a complex qualm. After the hippie movement, Americans moved into the age of disco in the 1970s and with disco came cocaine. Although psychedelics were still somewhat popularized, the era of the “Summer of ‘69” had surely passed. In 1971 after President Richard Nixon had declared a “war on drugs” in light of the widespread use of LSD, harsher penalties were enforced on recreational drugs as a whole and deterred such activities to a certain extent (DPA, 2018). It would seem that since the widespread use of psychedelics in the 1960s, the focus has moved to other far more harmful drugs, such as highly addictive pharmaceutical drugs and opiates/opioids. I have read many books from authors such as Michael Pollan, Dr. Richard Strassman, and Timothy Leary and truly believe that psychedelics hold much more than just a “trip”. However, I do not believe it has ever been in the interest of any government in the history of mankind to expand the consciousness of the general populous. Therefore, these drugs remain regulated, restricted, and punishable upon use. My hope is that the archaic mindset of the previous generations of man will come to an end and further use and research (such as Dr. Mithoefer’s) of psychedelics will continue and become more mainstream.

9.  What surprised me most

The most surprising finding in my research is most definitely that some psychedelics (despite being federally illegal) are today being used in clinical research to treat a variety of mental disorders. This is proof that psychedelics still may yet have a chance to reveal some secrets of the human brain and humanity as a whole. I also had a personal realization that I was surprised I had not thought about previously. If the 1960s counter-culture had perhaps operated with a bit more discretion, LSD and other psychedelics may have had a chance to gain social acceptance and even further medical use. Another surprising fact is that our own government admittedly used psychedelics on unsuspecting victims to observe their effects and in fact had their own scientists synthesize LSD and disperse it amongst the American public. This, of course, means that a percentage of the LSD produced during the 1960s, was produced by the United States government.

10.  Harm Reduction vs. Zero Tolerance Laws

Zero Tolerance laws are another perfect example of the archaic mindsets of our American politicians still in office. The only thing that these laws have proven to do are increase the number of Americans currently incarcerated, which in turn costs our entire country more money in prison related costs. Drug addictions, abuse, and mental illness are just a few of the most overlooked issues in the United States presently. Instead of tackling these issues head-on, we have instead tried to find a “quick fix” for these problems with overprescribing and incarceration. At this point, America and her citizens know full well that our government’s tactics in rectifying these issues has and are currently failing at an embarrassing rate. I believe we need to focus more energy on drug abuse/addiction and mental rehabilitation via psychopharmacology and psychiatry. Also, adopting legislation similar to that enacted in 2001 in Portugal with decriminalization of all drugs (to a certain degree) may benefit those in serious need of help (Ferreira, 2017). The key to solving our current drug epidemic does not lie with punishment; it simply lies with helping one another overcome and combat addiction.

thanks,

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Choose a country other than the United States and research its health care system.

Provide an overview of your selected country’s health care system and ANSWER all the questions below:

· Describe any foreign health care system by answering the following questions:

o How do the citizens of the country access health care?

o How do the citizens of the country pay for health care?

o What is the quality of the health care they receive? Are there unique services provided?

o How is technology used within the system to benefit patients and health outcomes?

o What are at least one pro and one con of your chosen country’s system?

· Identify at least two examples of similarities between your selected country and theS. health care system.

· Differentiate between S. health care and your chosen country’s health care system by sharing at least two differences.

You must use a government resources from your chosen country and the textbook ONLY Batnitzky, A., Hayes, D., & Vinall, P. E. (2018). The U.S. healthcare system: An introduction. Retrieved from https://content.ashford.edu

· Chapter 8: Public Health and Policy

· Chapter 9: Healthcare Research

· Chapter 10: Healthcare and Technology

· Chapter 11: International Systems in Healthcare

ONLY your research and response. Wikipedia is not an acceptable source for any discussion or assignment. You may also want to review What Is CRAAP? A Guide to Evaluating Web Sources.

DUE 2/1/19 @8AM EASTERN STANDARD TIME ZONE

ATTACH TURNITIN REPORT WITH ANSWER

.

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"