Clinical Pharmacology

CAPSTONE 2: CLINICAL PHARMACOLOGY IN ACTION A 10-Drug Case Challenge Overview This assignment asks you to analyze a real-world clinical scenario through the lens of pharmacology by examining the medications used to manage a patient undergoing emergency surgery and postoperative recovery. By identifying and evaluating each drug’s mechanism of action, therapeutic purpose, and side effect profile, you will apply foundational pharmacologic principles to a complex, integrated case. Advice from the Instructor This capstone challenges you to think like a healthcare professional analyzing a complete patient case. Read each scenario carefully and choose ONE. In this assignment, you will identify 10 medications used in your chosen scenario. When explaining mechanisms of action, go beyond simple definitions and explain how the drug works at the molecular or systems level. For therapeutic indications, connect the drug’s mechanism to why it’s specifically chosen for this patient’s condition. Remember that real clinical practice involves multiple medications working together, so consider how each drug fits into the overall treatment plan. Core Requirements Choose ONE of the following scenarios for your Capstone project. Clinical Scenarios – Choose ONE 1. Emergency Appendectomy in a Teenager A 16-year-old boy is admitted with worsening abdominal pain and is diagnosed with acute appendicitis. In the emergency department, he was started on ceftriaxone and metronidazole to cover infection, along with ondansetron for nausea and morphine for pain. In the operating room, anesthesia is induced with propofol, and he is maintained on sevoflurane while muscle relaxation is provided with rocuronium. During the procedure, he also receives fentanyl for analgesia. After surgery, he is transitioned to acetaminophen and ibuprofen for ongoing pain management, and he is started on low-dose enoxaparin injections for clot prevention while he remains in bed recovering. 2. Hip Replacement Surgery in an Elderly Patient with COPD An 82-year-old woman with severe hip arthritis and chronic obstructive pulmonary disease is admitted for elective hip replacement. On the morning of surgery, she uses her albuterol inhaler and scheduled fluticasone inhaler to optimize her lung function. Because she has a prior history of deep vein thrombosis, her apixaban is held prior to surgery. In the operating room, anesthesia is induced with propofol, maintained with desflurane, and muscle relaxation is provided with vecuronium. She receives intraoperative analgesia with fentanyl and prophylactic antibiotics with cefazolin. After surgery, she restarted on apixaban, given acetaminophen for baseline pain control, and managed with hydromorphone for breakthrough pain. 3. Coronary Artery Bypass Graft (CABG) Surgery A 65-year-old man with multivessel coronary artery disease is admitted for bypass surgery. In the preoperative unit, he continues his aspirin, atorvastatin, and metoprolol. Intraoperatively, anesthesia is induced with etomidate and maintained with isoflurane, while succinylcholine is used for intubation. During the procedure, anticoagulation is achieved with heparin, and analgesia is provided with fentanyl. After surgery, he is started on a proton pump inhibitor (pantoprazole) to protect the stomach, and intravenous furosemide is used to manage fluid balance. He is restarted on clopidogrel to protect the bypass grafts, and his beta-blocker and statin are continued during recovery. Step-by-Step Instructions Step 1: Choose and Analyze Your Scenario Choose ONE of the three clinical scenarios and read it carefully again. Begin by thoroughly reviewing the provided patient case. Pay close attention to the patient’s diagnosis, medical history, and progression through admission, surgery, postoperative care, and recovery. List each of the 10 medications administered during the case. Step 2: Create a Drug Profile for Each Medication (10 total) For each drug used in the scenario, create a structured response that includes the following: Drug Name Mechanism of Action: Explain how the drug works at the molecular or systems level Therapeutic Indication: This should not be a one-word answer, but explain why this drug might be chosen in this scenario based on its mechanism and side effects Common and Serious Side Effects Use the provided table format to list each medication’s details. Drug Profile Template You will use this type of table format to list each of the 10 medications. A downloadable template is provided. Component Details Drug Name [Enter drug name here] Mechanism of Action: Explain how the drug works at the molecular or systems level. Therapeutic Indication: Why is this drug used in this clinical case? Common and Serious Side Effects: List adverse effects. Detailed Requirements Download the Capstone Drug Analysis Table template provided. Complete one full table for each medication (10 tables total), entering your responses directly into the document. Once you have completed all 10 tables, save your document with your name in the file title (e.g., Lastname_Pharm103_Capstone_2.docx). Upload the complete document to the course. Resources Make sure to review these helpful resources associated with this capstone: