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Case Studies - Johns Hopkins Medicine

MDI to four to five times/day when she has a flare-up. However, her husband has been out of work for more than a year, and their only source of income is her Social Security check. In addition to these substantial education responsibilities, advanced practice pharmacists who are Board CertifiedAdvanced. Diabetes Managers (BC-ADMs) play an expanded role that encompasses disease state management. This includes performing clinical assessments and limited physical examinations; recognizing the need for additional care; making referrals as needed; ordering and interpreting specific laboratory tests; integrating their pharmacy patient care plans into patients total. The former refers to the impact of treatment on patients overall medical status and quality of life and should emphasize patient-oriented evidence that matters (poems) rather than disease-oriented evidence (DOEs). Therapeutic endpoints include the anticipated and desired clinical effects from drug therapy that are expected, ultimately, to achieve the desired outcome(s). She says she occasionally takes a little more insulin when she notes high blood glucose readings, but she has not been instructed on the use of an insulin adjustment algorithm. Her other routine medications include the fluticasone metered dose inhaler (Flovent MDI two puffs twice a day; salmeterol MDI (Serevent MDI two puffs twice a day; naproxen (Naprosyn 375 mg. She denies use of nicotine, alcohol, or recreational drugs; has no known drug allergies; and is up to date on her immunizations. B.L.s chief complaint now is increasing exacerbations of asthma and the need for prednisone tapers. Case Studies in Geriatric Medicine and Patient Care.

She reports that during her last round of prednisone therapy, her blood glucose readings increased to the range of 300400 mg/dl despite large decreases in her carbohydrate intake. She reports that she increases the frequency of her fluticasone MDI, salmeterol MDI, and albuterol.