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.

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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.

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: Annotated Bibliography

Revisit Miriam, the graduate nurse whose specialty area is critical care. As Miriam’s practicum experience proceeds, she is increasingly interested in new technology and best practices in the care of acutely ill patients. Looking ahead to her work as a nurse educator, Miriam has begun researching scholarly articles on new developments in critical care. Her purpose is to both expand her own knowledge and create an annotated bibliography that she can share with her students.

In this Assignment, you gather information on advancements in your practicum specialty.

To Prepare

• Reflect on your specialty of interest and your practicum experience. What key topics, processes, best practices, advancements, and technologies have you seen or heard about?
• Search the Walden Library for articles on any or all of these dimensions. Keep in mind that your focus is on current developments and that articles you select should have been published within the last three years.

To Complete

• Create an annotated bibliography that consists of 10 scholarly, peer-reviewed articles.
• For each article:
  • Provide a brief summary (4–5 sentences).
  • Explain why this article is relevant (1–2 sentences).
  • Explain the application of the findings of the article to practice (1–2 sentences).

 

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 USE THIS FORMAT TO ADD TO EACH DRUG.

THEN AFTER EACH DRUG ENTER INFO.

 YOU CAN FIND THIS INFORMATION ANYWHERE>

ENTER MEDICATION WITH INFO BELOW.

SHORT ANSWER. EACH SECTION CAN BE A SENTENCE OR SHORTER, NO NEED FOR PARAGRAPHS. 

Drug Name (generic, Trade Name): (FOR EXAMPLE : ATIVAN)

 

Classification: Anti anxiety, Benzodiazepine, Anticonvulsant

 

Action: Act on the brain and nerves (central nervous system) to produce a calming effect that relieve symptoms of anxiety.  

 

Available Forms: Tablet, Intravenous

 

 Diagnosis/indications:  It is indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms.

 

Most Common Side Effects: Dizziness, Drowsiness, Nausea,Vomiting

 

Drug/Drug and/or Drug/food Interactions : This drug isn’t to be taken with other medications that can lower the blood pressure.

 

Nursing Interventions Needed When Giving This Medication: Explain to patient to not drive while taking this medication

 

Patient Education: Do not take this medication with other benzodiazepines

THESE ARE THE DRUGS BELOW:

  

1. Alprazolam (Xanax)

2. Amitriptyline (Elavil)

3. Amoxapine (Asendin)

4. Bupropion (Wellbutrin, Zyban)

5.  Buspirone ( Buspar)

6. Clomipramine (Anafranil)

7. Clonazepam (Klonopin)

8. Desipramine (Norpramine)

9. Desvenlafaxine (Pristiq)

10. Diazepam (Valium)

  

1. Doxepin (Adapin, Sinequan, Zonalon)

2. Duloxetine (Cymbalta)

3. Escitalopram (Lexapro)

4. Fluoxetine (Prozac)

5. Gabapentin (Neurontin)

6. Imipramine(Tofranil)

7. Isocarboxazid (Marplan)

8. Lamotrigine (Lamictal)

9. Lorazepam (Ativan)

10. Mirtazapine(Remeron)

11. Nortriptyline (Pamelor, Aventy)

  

1. Sertraline (Zoloft)

2. Topiramate(Topamax)

3. Tranylcypromine (Parnate)

4. Trazodone (Desyrel)

5. Venlafaxine (Effexor)

6. Isocarboxazid (Marplan)

7. Phenelzine (Nardil)

8. Tranlcypromine (Parnate)

9. Thioridazine (Mellaril)

10. Trifluopperazine (stelazine)

11. Fluphenazine (Prolixin)

12. Haloperidol (Haldol)

13. Molindone (Moban)

14. Clozapine (Clozaril)

 

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