Case studies are a useful way for you to apply your knowledge of pharmacokinetic and pharmacodynamic aspects of pharmacology to specific patient cases and health histories. For your week 4 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis. DIRECTIONS For each of the scenarios below, answer the questions using your learning resources, Medscape, and clinical practice guidelines (ie JNC 8, AHA, ACC etc). Lecturio is an optional resource but highly recommended. Be sure to thoroughly answer ALL questions. When recommending medications, write out a complete medication order. What would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply) and refill information. Also state if you would continue, discontinue or taper the patient’s current medications. Review and discuss ALL labs and possible interactions. Use at least 3 sources for each scenario and cite sources using APA format; include in-text citations. You do not need an introduction or conclusion paragraph. Please also review assignment rubric. SCENARIO 1 What are the errors in the following prescriptions (5 total)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)? linaglipton 5 mg PO daily #30 5 RF Tresiba inject 10 units SC TID with meals #1 box of 5 pens 1 RF tiotropium (Spiriva) 2.5 mcg PO BID #60 1 RF Qulipta 60 mg PRN for migraine #30 1 RF levothyroxine 88 mg PO daily #30 5 RF SCENARIO 2 PK is a 16-year-old female diagnosed with mild persistent asthma since age 12. During her visit today, she reports having to use her albuterol MDI 3 days per week over the past 2 months. Over the past week she has been using albuterol at least once per day. She reports being awakened by a cough 5 nights during the last month. She also has a fluticasone MDI, which she uses “most days of the week.” Her current medications include: Flovent HFA 44 mcg two puffs BID, Proventil HFA two puffs Q 4-6 hr PRN shortness of breath, fexofenadine 180 mg po daily, diphenhydramine 50 mg qhs prn. What treatment plan would you implement for PK? What medication changes would you make? Include a complete medication order. How would you monitor the effectiveness of this plan, and what patient education would you provide? SCENARIO 3 ES is a 45-year-old African American male that was prescribed bisoprolol for his high blood pressure. Blood pressure today is 142/89 HR 60 RR 15. He states that he only occasionally takes the medication because he does not like the side effects. What information would you provide to the patient at his visit? What is his goal blood pressure? How is hypertension treated per current guidelines (JNC 8, ACC, AHA)? How would you improve his treatment? Include a complete medication order. SCENARIO 4 TF is a 60 year old male presenting to the clinic for medication refills. Current medications include acetylcholinesterase inhibitor donepezil 5 mg po qhs, anti-amyloid monoclonal antibody lecanemab (Leqembi) 10 mg/kg IV every 2 weeks for early Alzheimer’s disease, and atorvastatin 40 mg po daily. His lab work today includes: fasting BG is 195 mg/dL; HgA1C = 8.5%. Basic Metabolic Profile (BMP) is normal except for Cr 1.9 and eGRF 28. What is his goal A1C? Please SELECT and DISCUSS which of the following would be best to prescribe for TF: 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

Question

Case studies are a useful way for you to apply your knowledge of pharmacokinetic and pharmacodynamic aspects of pharmacology to specific patient cases and health histories. For your week 4 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis. DIRECTIONS For each of the scenarios below, answer the questions using your learning resources, Medscape, and clinical practice guidelines (ie JNC 8, AHA, ACC etc). Lecturio is an optional resource but highly recommended. Be sure to thoroughly answer ALL questions. When recommending medications, write out a complete medication order. What would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply) and refill information. Also state if you would continue, discontinue or taper the patient’s current medications. Review and discuss ALL labs and possible interactions. Use at least 3 sources for each scenario and cite sources using APA format; include in-text citations. You do not need an introduction or conclusion paragraph. Please also review assignment rubric. SCENARIO 1 What are the errors in the following prescriptions (5 total)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)? linaglipton 5 mg PO daily #30 5 RF Tresiba inject 10 units SC TID with meals #1 box of 5 pens 1 RF tiotropium (Spiriva) 2.5 mcg PO BID #60 1 RF Qulipta 60 mg PRN for migraine #30 1 RF levothyroxine 88 mg PO daily #30 5 RF SCENARIO 2 PK is a 16-year-old female diagnosed with mild persistent asthma since age 12. During her visit today, she reports having to use her albuterol MDI 3 days per week over the past 2 months. Over the past week she has been using albuterol at least once per day. She reports being awakened by a cough 5 nights during the last month. She also has a fluticasone MDI, which she uses “most days of the week.” Her current medications include: Flovent HFA 44 mcg two puffs BID, Proventil HFA two puffs Q 4-6 hr PRN shortness of breath, fexofenadine 180 mg po daily, diphenhydramine 50 mg qhs prn. What treatment plan would you implement for PK? What medication changes would you make? Include a complete medication order. How would you monitor the effectiveness of this plan, and what patient education would you provide? SCENARIO 3 ES is a 45-year-old African American male that was prescribed bisoprolol for his high blood pressure. Blood pressure today is 142/89 HR 60 RR 15. He states that he only occasionally takes the medication because he does not like the side effects. What information would you provide to the patient at his visit? What is his goal blood pressure? How is hypertension treated per current guidelines (JNC 8, ACC, AHA)? How would you improve his treatment? Include a complete medication order. SCENARIO 4 TF is a 60 year old male presenting to the clinic for medication refills. Current medications include acetylcholinesterase inhibitor donepezil 5 mg po qhs, anti-amyloid monoclonal antibody lecanemab (Leqembi) 10 mg/kg IV every 2 weeks for early Alzheimer’s disease, and atorvastatin 40 mg po daily. His lab work today includes: fasting BG is 195 mg/dL; HgA1C = 8.5%. Basic Metabolic Profile (BMP) is normal except for Cr 1.9 and eGRF 28. What is his goal A1C? Please SELECT and DISCUSS which of the following would be best to prescribe for TF: 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

Dan Palmer · Accepted Answer

Pharmacological decisions must align with patient-specific data, including clinical symptoms, history, comorbidities, and lab values. Understanding the pharmacokinetic and pharmacodynamic properties of medications is essential when treating patients with gastrointestinal, hepatobiliary, and systemic concerns (Rosenthal & Burchum, 2021). This paper evaluates four clinical scenarios requiring medication review and treatment modification. The purpose of this paper is to assess medication errors, propose treatment plans, and apply evidence-based guidelines for optimal patient outcomes. SCENARIO 1: Prescription Review Linaglipton 5 mg PO daily #30 5 RF Error: Misspelling; the correct drug name is linagliptin. Corrected order: Linagliptin 5 mg PO daily №30 tablets with 5 refills. Class: DPP-4 inhibitor MOA: Linagliptin inhibits the enzyme dipeptidyl peptidase-4 (DPP-4), which slows the breakdown of incretin hormones (Yu et al., 2023). Increased incretin levels enhance glucose-dependent insulin secretion and suppress glucagon release. This leads to improved glycemic control by lowering post-meal glucose spikes without causing significant hypoglycemia (Yu et al., 2023). It is particularly useful in managing type 2 diabetes in combination with lifestyle interventions. 2. Tresiba inject 10 units SC TID with meals #1 box of 5 pens 1 RF Error: Frequency error; Tresiba (insulin degludec) is long-acting and should be dosed once daily. Corrected order: Insulin degludec (Tresiba) 10 units SC once daily №1 box (5 pens) with 1 refill. Class: Long-acting insulin MOA: Insulin degludec regulates blood glucose by enhancing peripheral glucose uptake, especially in muscle and fat tissues, and reducing glucose production in the liver (Chen et al., 2023). It mimics the body’s natural basal insulin, maintaining steady insulin levels over 24 hours (Chen et al., 2023). This action helps manage fasting blood glucose levels and supports overall glycemic control in patients with diabetes mellitus. 3. Tiotropium (Spiriva) 2.5 mcg PO BID #60 1 RF Error: Route error; tiotropium is inhaled, not taken orally. Corrected order: Tiotropium (Spiriva Respimat) 2.5 mcg/inhalation, inhale 2 puffs once daily №1 inhaler with 1 refill. Class: Long-acting anticholinergic MOA:Tiotropium works by selectively blocking M3 muscarinic receptors in the smooth muscles of the airways, preventing acetylcholine from binding (Kaplan & Chang, 2021). This inhibition leads to sustained bronchodilation, improving airflow and reducing symptoms in patients with chronic obstructive pulmonary disease (COPD) and asthma (Kaplan & Chang, 2021). Its long-acting effect allows for once-daily dosing to maintain respiratory function and ease breathing. 4. Qulipta 60 mg PRN for migraine #30 1 RF Error: Missing frequency and max dose. Corrected order: Qulipta (atogepant) 60 mg PO once daily for migraine prevention №30 tablets with 1 refill. Class: CGRP receptor antagonist MOA: Blocks CGRP receptor to prevent migraine attacks. 5. levothyroxine 88 mg PO daily #30 5 RF Error: Incorrect unit; should be mcg not mg. Corrected order: Levothyroxine 88 mcg PO daily №30 tablets with 5 refills. Class: Thyroid hormone replacement MOA: Levothyroxine is a synthetic form of thyroxine (T4), a hormone normally produced by the thyroid gland (Rosenthal & Burchum, 2021). It is converted to the active form, triiodothyronine (T3), in peripheral tissues. This hormone regulates metabolism, energy production, and protein synthesis. In hypothyroid patients, levothyroxine restores normal hormone levels, improving symptoms like fatigue, weight gain, and cold intolerance. SCENARIO 2: Asthma Management in Adolescent PK's symptoms indicate poorly controlled mild persistent asthma, given frequent use of albuterol and nighttime symptoms. Step-up therapy is warranted per GINA guidelines. Discontinue: Flovent HFA 44 mcg BID New order: Fluticasone-salmeterol (Advair HFA) 115/21 mcg, 2 puffs BID №60 inhalations with 3 refills. Continue: Albuterol inhaler PRN Education: Educate the patient on correct inhaler use to ensure effective drug delivery. Emphasize rinsing the mouth after each use to prevent oral thrush. Advise avoiding known allergens and irritants that may trigger asthma symptoms. Stress the importance of daily medication adherence, even when asymptomatic, to maintain long-term asthma control and reduce the need for rescue inhaler use (Rosenthal & Burchum, 2021). Monitoring: Monitor the patient’s asthma control regularly using the Asthma Control Test (ACT) to evaluate symptom management. Track the frequency of rescue inhaler use, as increased use may indicate poor control (Rosenthal & Burchum, 2021). Assess for potential side effects from controller medications, such as oral thrush or hoarseness, and adjust the treatment plan accordingly to optimize therapeutic effectiveness and safety. SCENARIO 3: Hypertension Management in African American Male ES is undertreated due to poor adherence. Per ACC/AHA guidelines, goal BP is <130/80 mmHg. Bisoprolol is not first-line in African American patients. Discontinue: Bisoprolol New order: Amlodipine 5 mg PO daily №30 tablets with 3 refills. Add: Hydrochlorothiazide 12.5 mg PO daily №30 tablets with 3 refills. Education: Educate the patient about recognizing and managing potential medication side effects, such as swelling or dizziness. Emphasize the importance of taking antihypertensive medications consistently each day to maintain blood pressure control (Ogunniyi et al., 2021). Introduce the DASH diet, which emphasizes fruits, vegetables, whole grains, and low sodium intake, to support lifestyle changes that complement pharmacologic treatment for hypertension. Monitoring: Monitor the patient’s blood pressure by scheduling a follow-up visit in 2 to 4 weeks to assess treatment effectiveness (Ogunniyi et al., 2021). Evaluate for signs of peripheral edema, a possible side effect of calcium channel blockers. Additionally, check serum electrolytes, especially potassium and sodium levels, to detect any imbalances that may arise from diuretic use or antihypertensive therapy (Rosenthal & Burchum, 2021). SCENARIO 4: Diabetes Management in a Patient with Alzheimer’s and CKD TF’s eGFR is 28 and A1C is 8.5%. ADA recommends a goal A1C of <8% in patients with comorbid conditions. Some antidiabetic drugs are contraindicated in CKD. Avoid: Metformin (contraindicated with eGFR <30); glyburide and glimepiride (risk of hypoglycemia) Preferred agent: Semaglutide (Ozempic) – shown to improve glycemic control with renal protection. New order: Semaglutide (Ozempic) 0.25 mg SC once weekly for 4 weeks, then increase to 0.5 mg once weekly №1 pen with 1 refill. Continue: Donepezil, Leqembi, atorvastatin Education: Instruct the patient to administer the subcutaneous injection in the thigh or abdomen, rotating sites to prevent irritation. Educate on recognizing early signs of adverse effects such as persistent nausea, vomiting, or severe abdominal pain, which may indicate pancreatitis (American Diabetes Association, 2024). Encourage prompt reporting of these symptoms to ensure timely medical evaluation and prevent complications from GLP-1 receptor agonist therapy. Monitoring: Schedule a follow-up to recheck the patient’s HbA1c in three months to assess glycemic control. Monitor renal function regularly through serum creatinine and eGFR due to existing kidney impairment (Rosenthal & Burchum, 2021). Observe for gastrointestinal side effects such as nausea, vomiting, or diarrhea, which are common with GLP-1 receptor agonists, and adjust the treatment plan if necessary. Conclusion Effective pharmacologic therapy must be individualized by integrating current guidelines, patient-specific factors, and medication safety. In these four scenarios, we identified prescription errors, improved asthma and hypertension control, and selected safe diabetes management strategies for a patient with renal impairment. These cases emphasize the need for precise prescribing, comprehensive patient education, and diligent monitoring to promote safety and therapeutic success. References American Diabetes Association (ADA). (2024). Standards of Medical Care in Diabetes. https://doi.org/10.2337/dc24-S011 Chen, B. Z., Li, W. X., Feng, Y. H., Zhang, X. P., Jiao, J., Li, Z. L., ... & Guo, X. D. (2023). Functional insulin aspart/insulin degludec-based microneedles for promoting postprandial glycemic control. Acta Biomaterialia, 171, 350-362. https://doi.org/10.1016/j.actbio.2023.09.010 Kaplan, A., & Chang, K. L. (2021). Tiotropium in asthma–perspectives for the primary care physician. Postgraduate Medicine, 133(5), 552-564.https://doi.org/10.1080/00325481.2020.1816329 Ogunniyi, M. O., Commodore-Mensah, Y., & Ferdinand, K. C. (2021). Race, ethnicity, hypertension, and heart disease: JACC focus seminar 1/9. Journal of the American College of Cardiology, 78(24), 2460-2470. https://www.jacc.org/doi/abs/10.1016/j.jacc.2021.06.017 Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier. Yu, H. Y., Sun, T., Wang, Z., Li, H., Xu, D., An, J., ... & Feng, J. (2023). Exendin-4 and linagliptin attenuate neuroinflammation in a mouse model of Parkinson’s disease. Neural Regeneration Research, 18(8), 1818-1826. https://doi.org/10.4103/1673-5374.360242

Criteria	Ratings	Pts
Scenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.	15 to >11.0 ptsExcellentMedication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate. 11 to >7.0 ptsGoodMedication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues. 7 to >3.0 ptsFairMedication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient. 3 to >0 ptsPoorMedication selected is inappropriate or would not be provided based on patient unique characteristics.	15 pts
Scenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.	3 ptsCompleteWritten medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. 0 ptsPoorThe prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.	3 pts
Scenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.	4 ptsExcellentReferences for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.	4 pts
Scenario 1: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	3 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	3 pts
Scenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.	15 to >11.0 ptsExcellentMedication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate. 11 to >7.0 ptsGoodMedication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues. 7 to >3.0 ptsFairMedication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient. 3 to >0 ptsPoorMedication selected is inappropriate or would not be provided based on patient unique characteristics.	15 pts
Scenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.	3 ptsCompleteWritten medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. 0 ptsPoorThe prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.	3 pts
Scenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.	4 ptsExcellentReferences for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.	4 pts
Scenario 2: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	3 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	3 pts
Scenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.	15 to >11.0 ptsExcellentMedication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate. 11 to >7.0 ptsGoodMedication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues. 7 to >3.0 ptsFairMedication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient. 3 to >0 ptsPoorMedication selected is inappropriate or would not be provided based on patient unique characteristics.	15 pts
Scenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.	3 ptsCompleteWritten medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. 0 ptsPoorThe prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.	3 pts
Scenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.	4 ptsExcellentReferences for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.	4 pts
Scenario 3: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	3 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	3 pts
Scenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.	15 to >11.0 ptsExcellentMedication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate. 11 to >7.0 ptsGoodMedication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues. 7 to >3.0 ptsFairMedication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient. 3 to >0 ptsPoorMedication selected is inappropriate or would not be provided based on patient unique characteristics.	15 pts
Scenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.	3 ptsCompleteWritten medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. 0 ptsPoorThe prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.	3 pts
Scenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.	4 ptsExcellentReferences for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.	4 pts
Scenario 4: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	3 ptsExcellentUses correct grammar, spelling, and punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar, spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	3 pts

Case studies are a useful way for you to apply your knowledge of pharmacokinetic and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.

Written By: Dan Palmer, RN

Edited By: Ethan Green, MSN-FNP