NUR231 Drug Therapy

Even though he is taking ondansetron, he continues to experience ongoing nausea, and is aware that his cancer is not improving. He is so unwell most days, that Nigel is considering declining all cancer medications, and remaining at home with his family until his approaching death.

1. From your knowledge of pathophysiology, explain the links between Nigel’s lung cancer, difficulty breathing, and metastases.

2. Consider Nigel’s secondary liver cancer – how might this impact on the pharmacokinetics of his chemotherapy medications? Ensure that you include an appropriate consideration of hepatic first pass metabolism in your answer.

3. Describe how his chemotherapy medications can be effective on treating his lung cancer.

4. Compare the mechanism of action of his current chemotherapy medications (cisplatin and docetaxel) with an alternative cancer medication that he is not taking, nivolumab.

5. Cisplatin, docetaxel and nivolumab may all cause nausea and vomiting. Discuss one main reason why such medications can cause such symptoms, even though none of
these are administered orally. Ensuring that you focus on the mechanisms that directly affect the gastrointestinal system.

6. Discuss one main adverse reaction that may occur as a result of Nigel’s morphine administration, and how would this be managed.

She has a medical history of severe viral hepatitis from when she spent 6 months travelling overseas for at the age of 22. This has resulted in her having permanent liver dysfunction.

1. Explain two main reasons why Kelly’s sciatica has increased during her pregnancy. Ensure that you include relevant pathophysiology in your answer.

2. Consider Kelly’s liver dysfunction – how might this impact on the pharmacokinetics of her paracetamol and metoclopramide. Ensure that you include an appropriate consideration of hepatic first pass metabolism in your answer.

3. Describe how her current anti-emetic medication can be effective in reducing nausea and vomiting.

4. Compare the mechanism of action of her current anti-emetic medication (metoclopramide) with an alternative medication that she is not taking, ondansetron.

5. Discuss one main reason why pregnancy can cause nausea and vomiting, ensuring that you focus on the mechanisms that directly affect the gastrointestinal system.

6. Kelly may be offered the use of pethidine for sciatica during this stage of her pregnancy, and during childbirth. Discuss one main adverse reaction that may occur as a result of pethidine administration, and how would this be managed.

Leave a Reply