NUR 641E Topic 1: General Physiological And Pathophysiological Concepts
Objectives:
Describe principles of immunology in disease processes.
Evaluate the inflammatory response as a defense mechanism.
Evaluate the principles of cellular alterations in infection and the medications that treat infection.
Describe a pharmacological intervention using an evidence-based treatment guideline.
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NUR 641E Topic 1: General Physiological And Pathophysiological Concepts Topic 1 DQ 1
Start Date
Status
Published
Assessment Description
Part 1
What are the differences between primary and secondary line of defense? What factors interfere with these mechanisms? How are these levels of immunity affected in a child, an elderly person, or a person with a chronic disease? Include active, passive, innate, and acquired immunity.
Part 2
Choose an inflammatory or infectious process and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Make sure that you select a different medical condition than your peers. Include the name of the medical condition in the subject line so that the medical condition can be followed. Include your references in APA style.
Proton Pump Inhibitor (Omeprazole)
Proton-pump inhibitors, or PPIs, are a group of drugs that are best known for treating acid-related illnesses. When used with other natural medicines, this effect can help heal a peptic ulcer, treat gastroesophageal reflux disease, treat Barrett’s esophagus, and even get rid of Helicobacter pylori (Ahmed & Clarke, 2021). From my past work as a home health nurse, I know that most older patients take Omeprazole, especially if they need to take more than one medication. Some of the patients were given eight or more medications, and Omeprazole was one of them. Most of the time, they will be sent home from the hospital with new medicines. It was always hard to work with the patient’s different doctors to make sure they were taking the right medication for the long term and not just for the short term. When I first met a patient, I asked him why he was taking Omeprazole. He told me it was because of GERD from all the other medicines he was taking. So, we have to be careful with the medicines our older patients take. Because the more medicines a person takes, the more likely they are to have bad effects from those medicines. So, it’s important to teach the patient, give them an up-to-date list of their medications, and tell them or their family that they need to bring all of their medications with them every time they see a doctor to avoid getting duplicate or unnecessary prescriptions.
How Proton Pump Inhibitor Works in the Body
Absorption
These drugs are absorbed by the upper part of the small intestine. When they reach the parietal cells of the stomach, they change the cells (Ahmed & Clarke, 2021). PPIs stop an enzyme in the parietal cells called the proton pump. This enzyme is the last part of the process that lets acid into the stomach, and it does a great job of it.
Metabolism
Omeprazole is broken down by the CYP2C19 and CYP3A4 isozymes, which are part of the cytochrome P450 enzyme system in the liver. It has a short half-life of 30 minutes to an hour in healthy people and 3 hours in people with liver problems (Shah, 2020).
Distribution
Omeprazole starts to work less quickly an hour after you take it. It takes about two hours for the drug to have all of its effects. The effects of the drug last for about three days after you take it. When you take medicine every day, it will take four days for the effects to stop getting worse (Shah, 2020).
Excretion
The main way omeprazole metabolites leave the body is through the urine (Shah, 2020)
Reference
Ahmed, A., & Clarke, J. O. (2021, August 1). Proton pump inhibitors (PPI) – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK557385/
Shah, G. W. (2020, October 17). Omeprazole – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK539786/
Topic 1 DQ 2
GO TO DISCUSSION
Points
5
Status
Published
Assessment Description
Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.
Topic 1 DQ 2
Mar 3-7, 2022
Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.
REPLY TO DISCUSSION
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Replies to Cristina Alimon
Cyclophosphamide
Cyclophosphamide, with the brand name of Cytoxan, is one of the medications given for Goodpasture disease to suppress the immune system in making anti-glomerular basement membrane (GBM) antibodies. Primarily this medication is for cancer like ovaries, breasts, blood, and others.
Mechanism of action
Cyclophosphamide is a cancer drug under a class of alkylating agents. The CYP450 system converts cyclophosphamide and ifosfamide to hydroxylated intermediates in the liver. The active chemicals phosphoramide mustard, and acrolein, are formed from the hydroxylated intermediates. The phosphoramide mustard reacts with DNA, causing cytotoxicity (LaPlant, & May 2019). Cyclophosphamide slows the development of cancer cells, which the body eventually destroys. Other side effects may develop because cyclophosphamide affects normal cell growth.
Hints for monitoring
Cyclophosphamide can temporarily reduce white blood cell counts, increasing the risk of infection and reducing the platelet count required for blood clotting (Mayo Clinic, 2022). Particular care must be taken to avoid infection or bleeding. Therefore, it is essential to instruct the patient to follow bleeding precautions. Avoiding contact sports and other circumstances that might cause bruising, cuts, and brushing or flossing teeth; monitor for signs of bleeding like bruises, blood in the urine or stools, or tiny red patches on the skin. Cyclophosphamide may reduce the body’s resistance, causing the vaccination to fail or the illness to occur; the patient should also avoid others who have received live virus vaccinations since they may spread the infection to the patient (Mayo Clinic, 2022).
Side effects
More common side effects are cough or hoarseness, fever or chills; lower back or side pain; missing menstrual periods; and painful or difficult urination (Mayo Clinic, 2022). The following side effects with high doses and long-term treatment are blood in the urine; dizziness, confusion, or agitation; fast heartbeat; joint pain; shortness of breath; swelling of the feet or lower legs; and unusual tiredness or weakness. Studies on nursing mothers show detrimental impacts on babies. It should be provided an alternative or discontinue nursing while using it.
Drug interaction
Cyclophosphamide has notable drug interactions with phenobarbital, phenytoin, digoxin, and anticoagulants (LaPlant, & May 2019). Chronic high dosages of phenobarbital enhance the metabolism and leukopenic action of cyclophosphamide. Therefore, warfarin’s impact is enhanced or decreased in individuals receiving warfarin plus cyclophosphamide (U.S. National Library of Medicine, 2021). NUR 641E Topic 1: General Physiological And Pathophysiological Concepts
References:
LaPlant, K., & May, P. (2019). Anticancer Drugs. In K. Whalen (Ed.), Lippincott® illustrated reviews: Pharmacology (7th ed.). Wolters Kluwer.
Mayo Clinic. (2022, February 14). Cyclophosphamide (Oral route, intravenous route) description and brand names – Mayo Clinic. https://www.mayoclinic.org/drugs-
