Ethical considerations may impact your treatment plan and communication with patients
You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Case Introduction
A 65-year-old male patient is presented to the clinic with a chief complaint of chest pain. He has a history of hypertension and hyperlipidemia, and he is currently taking atorvastatin and lisinopril. He is a non-smoker and drinks alcohol socially.
On physical examination, the patient's blood pressure is 140/90 mmHg, his pulse is 72 beats/minute, and his respiratory rate is 16 breaths/minute. His lungs are clear to auscultation, and his heart rhythm is regular.
An electrocardiogram (EKG) shows ST segment elevation in the inferior leads, which is consistent with an acute inferior wall myocardial infarction (MI). The patient is admitted to the hospital for cardiac catheterization and intervention.
Decision #1
Which medication should be prescribed for the patient to prevent thrombosis and embolization:
- Aspirin
- Clopidogrel
- Ticagrelor
- Bhatt DL, Steg PG, Bélanger F, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;360(24):2066-2076.
- The PLATO Investigators. Ticagrelor versus clopidogrel in high-risk patients with acute coronary syndrome. N Engl J Med. 2011;364(9):814-825.
- American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline on the treatment of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61(21):e78-e140.