WEEK 4 ASSIGNMENT (covers weeks 3-6)

SCENARIO 1

What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)?

Ubrelvy 200 mg PO at onset of migraine #30 0 RF

memantine/donepezil (Sinemet) 7/10 mg po once daily #30 1 RF

Stalevo 200 mg po TID #90 2 RF

levothyroxine 137 mg PO daily #30 3 RF

omeprazole (Protonix) 40 mg PO daily before breakfast #30 3 RF

SCENARIO 2

AL a 46-year-old female presents to clinic with chief complaint, “I get short of breath and wheeze almost every night. I also have a cough that wakes me up 2-3 times a week.” Her symptoms have been present almost 3 months. She has no prior hospitalizations or ED visits; no smoking history and no significant occupational exposures. She takes cetirizine for seasonal allergic rhinitis. NKDA. CBC normal, BP 114/68, HR 88, RR 18, SpO₂: 97%, spirometry: FEV₁ 70% predicted, FEV₁/FVC 0.65, reversibility testing: FEV₁ improves by 15% after albuterol inhalation, Peak Expiratory Flow (PEF): 65% of personal best. What is your diagnosis and treatment plan? How would you monitor treatment and what patient education would you provide?

SCENARIO 3

LV is a 9-year-old female that experiences brief staring episodes lasting ~10 seconds, occurring multiple times per day. Otherwise healthy, NKDA. Normal CBC, CMP, LFTs. She has been diagnosed with typical absence seizures. As her provider, your task is to initiate pharmacologic therapy. Write a complete medication order for LV, include monitoring parameters and patient/caregiver education points relevant to the medication and seizure management.

SCENARIO 4

TY is a 65-year-old male with poorly controlled type 2 diabetes and exhibits challenges with adherence. Current medications include donepezil 5 mg po qhs and losartan 50 mg po daily. His lab work today includes: BG 190 mg/dL, A1C 8.5%, K⁺ 4.1, Cr 1.9, eGRF 26, BP 125/76.

Which of the following would you prescribe:

canagliflozin (Invokana) 100 mg PO daily

exenatide (Byetta) 5 mcg SC twice daily

glimepiride 1 mg PO daily

glyburide 2.5 mg PO daily

metformin 500 mg PO daily

semaglutide (Ozempic) 0.25 mg SC once weekly

sitagliptin (Januvia) 50 mg PO daily

What is the classification and MOA of the drug you selected? What education would you provide and how would you monitor the effectiveness of the treatment plan? What is his goal A1C and blood pressure?

APA References for the scenarios are within past 5 years and include the appropriate clinical practice guideline if applicable.

Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

Struggling with where to start this assignment? Follow this guide to tackle your assignment easily!

This Week 4 assignment assesses your ability to identify prescribing errors, apply evidence-based treatment guidelines, and write complete, legally valid medication orders. Follow the steps below carefully to ensure you meet all grading criteria across Scenarios 1–4.

Scenario 1: Prescription Errors, Corrections, and Pharmacology

Step 1: Identify the Prescription Error

For each prescription, identify one clear error (e.g., incorrect dose, incorrect drug name, wrong units, brand/generic mismatch, or unsafe dosing).

Step 2: Rewrite the Prescription Correctly

Rewrite each prescription using all five required components of a valid medication order:

Medication name (generic preferred)
Dose
Route
Frequency
Quantity and refills

Ensure the corrected prescription is safe, accurate, and appropriate.

Step 3: Identify Drug Classification

State the pharmacologic class for each medication (e.g., CGRP antagonist, cholinesterase inhibitor).

Step 4: Explain the Mechanism of Action (MOA)

Briefly explain how each medication works at the physiological or receptor level.

Scenario 2: Adult Asthma Diagnosis and Management

Step 1: Establish the Diagnosis

Use the patient’s history, spirometry, reversibility testing, and symptoms to identify the most appropriate asthma classification.

Step 2: Develop a Treatment Plan

Select evidence-based pharmacologic therapy aligned with current asthma guidelines. Include both:

Controller medication(s)
Rescue medication(s)

Step 3: Monitoring Plan

Explain how you would monitor:

Symptom frequency
Lung function
Medication adherence and response

Step 4: Patient Education

Provide education on:

Inhaler technique
Trigger avoidance
When to seek urgent care
Importance of adherence

Scenario 3: Pediatric Absence Seizures

Step 1: Select First-Line Pharmacologic Therapy

Choose an appropriate first-line antiepileptic medication for typical absence seizures.

Step 2: Write a Complete Medication Order

Write a fully valid medication order including:

Drug, dose, route, frequency
Quantity and refills
Appropriate pediatric dosing

Step 3: Monitoring Parameters

Include necessary monitoring such as:

Lab tests
Adverse effects
Seizure frequency and response

Step 4: Patient and Caregiver Education

Provide education on:

Medication adherence
Side effects
Seizure safety precautions
When to seek medical attention

Scenario 4: Type 2 Diabetes With CKD and Adherence Challenges

Step 1: Evaluate Medication Options

Critically evaluate each listed medication option using:

Renal function (eGFR)
Hypoglycemia risk
Adherence considerations
Cardiovascular and renal benefit

Step 2: Select the Most Appropriate Medication

Choose one medication that is safest and most effective for this patient’s clinical profile.

Step 3: Classification and MOA

Identify the drug’s class and clearly explain its mechanism of action.

Step 4: Patient Education and Monitoring

Discuss:

Medication administration
Potential side effects
Monitoring parameters (A1C, renal function, glucose trends)

Step 5: Treatment Goals

State the patient’s:

Goal A1C
Blood pressure target

Ensure these align with current diabetes guidelines.

APA References and Writing Expectations

Use APA format
References must be within the past 5 years
Include current clinical practice guidelines where applicable
Maintain professional grammar, clarity, and organization
Ensure all medication orders are complete, accurate, and appropriate

Recommended Evidence-Based Resources

You may use the following authoritative sources:

American Diabetes Association (ADA): https://diabetes.org
Global Initiative for Asthma (GINA): https://ginasthma.org
American Academy of Neurology (AAN): https://www.aan.com
FDA Drug Database: https://www.fda.gov
UpToDate (institutional access): https://www.uptodate.com

Advanced Pharmacology Case Scenarios: Prescribing and Clinical Decision-Making