Discuss the pharmacodynamics & pharmacokinetics of one (1) common class of drug relevant to the chosen patient (300 words)

Exogenous Cushing Syndrome
This paper is on the disease Exogenous Cushing Syndrome and must be 1600 words. There are 4 questions and each question has a word limit so each question has to be precise and to the point. Patient information: Ms Maureen Smith is a 24 year old female who presented to her GP for ongoing gastrointestinal bleeding, abdominal pain and fatigue which has been worsening, and was referred to the local hospital for further investigation. Maureen was diagnosed with rheumatoid arthritis (RA) when she was 15 years old, and has experienced multiple exacerbations of RA which have required the use of high dose corticosteroids. She is currently taking 50mg of prednisolone daily, and has been taking this dose since her last exacerbation 2 months ago. Maureen also has type 2 diabetes which is managed with metformin. She is currently studying nursing at university and works part-time at the local pizza restaurant. On assessment, Maureens vital signs are: PR 88 bpm; RR 18 bpm; BP 154/106 mmHg; Temp 36.9C: SpO2 99% on room air. She has a body mass index (BMI) of 28kg/m2 and the fat is mainly distributed around her abdominal area, as well as a hump between her shoulders. Maureens husband notes that her face has become more round over the past few weeks. Her fasting BGL is 14.0mmol/L. Blood test results show low cortisol and ACTH levels, and high levels of low density lipoprotein cholesterol. She is awaiting a bone mineral density test this afternoon, and is currently collecting urine for a 24-hour cortisol level measurement. Impression: Exogenous Cushings syndrome Questions: 1. Outline the disease, causes, incidence and risk factors. Discuss the impact of the selected disease on the patient and their family (450 words). For the incidence please make sure it is incidence/statistics in Australia. 2. Discuss three (3) common signs and symptoms of the selected disease and explain the underlying pathophysiology of each (350 words) a. This can be done in the form of a table each point needs to be appropriately referenced. Please discuss Moon Face, Buffalo Hump and stretch marks of the abdomen. 3. Discuss the pharmacodynamics & pharmacokinetics of one (1) common class of drug relevant to the chosen patient (300 words) a. This does not mean specific drugs but rather the class that these drugs belong to. Choose either Corticosteroids or Biguanides as the drug class. 4. In order of priority, develop a nursing care plan for your chosen patient who has just arrived on the ward from ED. Nursing care plan goals, interventions and rationales must relate to the first 8 hours post ward admission (500 words) Make sure references are proper academic sources such as from databases. Credible sources and ones that can be accessed in Australia.

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