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BIOL334 Pharmacology:Quality Use of Medicines

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BIOL334 Pharmacology

Question:

Case study 1: The Asthmatic athlete

Manish is a 20-year-old aspiring cricketer who has been selected to play for Victoria in next season’s Sheffield Shield tournament. Manish is also an asthma sufferer and was first diagnosed with extrinsic asthma when he was 8 years-old. He has been prescribed numerous medications to manage his asthma over time including montelukast and salbutamol. He still takes salbutamol to relieve wheeziness and dyspnoea when required but is no longer prescribed montelukast as it caused adverse effects in his early teenage years. Since 16 years-of-age he has used an inhaler containing fluticasone (Flixotideâ accuhaler 250 micrograms) twice daily. 

After returning from cricket training one afternoon in September, Manish started to feel unwell. He was coughing a lot, felt hot and tight in the chest, and was very fatigued. He went to bed early but didn’t get a lot of sleep due to his cough. He used his inhaler containing salbutamol frequently to get some relief. Manish felt worse in the morning and noticed that he was coughing up green phlegm. He rang his coach and made an appointment to see one of the doctors at the club that afternoon. The doctor diagnosed Manish with a respiratory infection and prescribed amoxycillin; a ß-lactam antibiotic. She explained to Manish that he would feel better in a couple of days and that he must take all the tablets in the script.

Essay question

Evaluate the medications that Manish has been prescribed in his life to date. Please ensure that your short essay refers to Quality Use of Medicines in terms of a risk management plan for montelukast and mechanisms of antibiotic resistance. Use relevant peer-reviewed literature to support your arguments.

Case Study 2 – Holiday in endemic malaria location

Bill Gates was on a three week holiday to northern Thailand and was prescribed a daily 100 mg dosage of doxycycline as prophylactic to prevent infection by Plasmodium falciparum (protozoan parasite that can cause cerebral malaria) prior to leaving Australia. In times gone by, a traveller to a country where malaria was endemic would be given a quinine derivative such as chloroquine but resistance to these drugs is now widespread.

A week into his trip Bill began to suffer a stomach upset, mainly in the form of reflux from what he thought was either an adjustment to mineral content of the boiled water he was drinking or perhaps mild food poisoning. His doctor in Australia had indicated that doxycycline might provide some protection against infectious diarrhoea, and even though he did not feel like eating, continued with his daily doxycycline dosage. 

Expecting the condition to resolve quickly, he decided to use an over-the-counter preparation of an antacid to settle his stomach. This did seem to work initially, however 36 hours later, he developed a fever with associated chills and sweats and became concerned his stomach condition had become worse due to these additional symptoms.

Essay question

Critique the effectiveness of doxycycline for Bill and propose an alternative course of action. Use relevant peer-reviewed literature to support your arguments.

BIOL334 Pharmacology

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