Pharmacology Case Analysis: Medication Dosage Selection and Contraindication Protocol in Nursing Care

This pharmacology case analysis focuses on medication dosage selection, administration, and contraindication protocol in nursing care. The case study involves a patient with a fractured ankle and alcoholic cirrhosis who is taking acetaminophen for pain and fever. The analysis discusses the complications associated with acetaminophen, the factors that need to be addressed, and the interventions that nursing professionals should anticipate. The lifestyle factors of the patient are also discussed.

Running head: PHARMACOLOGY CASE ANALYSIS
Pharmacology case analysis
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1PHARMACOLOGY CASE ANALYSIS
Table of Contents
Introduction: 2
Case analysis: 2
Case discussion: 2
Question 1: 2
Question 2: 3
Question 3: 3
Conclusion: 4
References: 5

2PHARMACOLOGY CASE ANALYSIS
Introduction:
Medication errors and disregard for contraindication has to be one of the most impactful
further complicating factors and patient dissatisfaction (Antoine et al., 2013). This assignment
will focus on pharmacological management issues and medication dosage selection,
administration and contraindication protocol in nursing care taking the assistance of a case study.
Case analysis:
This case study the presence of patient of 46 year of age that had gone through fractured
ankle and has been admitted to the post operative department after an internal fixation of the
ankle. The past medical history of the patient exhibits alcoholic cirrhosis and also the fact that
the patient is overweight at 30 lbs. It has to be mentioned that the patient along with being
administered intravenous antibiotics is taking acetaminophen for reducing pain and fever. It has
to be mentioned that acetaminophen despite being a common pain medication has a few side
effects and contraindications, and in the case of the patient as well there are a few factors that
needs to be addressed.
Case discussion:
Question 1:
Acetaminophen is common pain medications used and yet there are many complications
associated with the medication. Overdose of this medication can lead to many liver complexities
specifically acute hepatic diseases. Overdose of this medication mainly leads to hepatotoxicity
and can even result in acute liver failure demanding transplantation or can even lead to death.
According to the past medical history of the patient she already suffers with alcoholic liver

3PHARMACOLOGY CASE ANALYSIS
cirrhosis, and any patient with the history of alcohol ingestion suffers from a highly elevated risk
of hepatotoxicity due to acetaminophen administration (Jaeschke, McGill & Ramachandran,
2012). Hence her past history of alcoholic liver cirrhosis is the factors that may lead the nursing
professional to question the order for acetaminophen instead of other pain medications.
Question 2:
It has to be mentioned in this context that overdose of acetaminophen can lead to severe liver
impairment. Higher concentration of this medication leads to acute hepatotoxicity of the liver
and facilities the liver failure which can even cause death. As the child consumed 30 tablets of
this medication, she will need to be given an antidote to prevent the liver damage. N-
acetylcysteine or NAC is considered to be the perfect antidote for acetaminophen and if
administered to the child at the right time it can even prevent liver damage (McGill et al., 2012).
Hence, the nursing professional should anticipate administering this medication to the child upon
her arrival to the emergency department.
Question 3:
Among the lifestyle factors mentioned in the case study of the patient the nursing
professionals must be the most concerned about the patient span of consuming 6 beers over 2
days. It has to be understood that both alcohol abuse and acetaminophen can lead to impairment
and failure of the liver (Schilling et al., 2010). Hence the nurse must be the most concerned about
the alcohol consumption of the patient and intervention planning and patient education is crucial
in this case.

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Conclusion:
On a concluding note, it can be stated that despite the side effects, acetaminophen continues
to be on the most abundantly used pain medication all over the world, for its fast and targeted
action. With a little careful dosage contraindications, this medication can be used safely within
the doors age limit of lesser than or equal to 2 grams.

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References:
Antoine, D. J., Dear, J. W., Lewis, P. S., Platt, V., Coyle, J., Masson, M., ... & Bateman, D. N.
(2013). Mechanistic biomarkers provide early and sensitive detection of acetaminophen‐
induced acute liver injury at first presentation to hospital. Hepatology, 58(2), 777-787.
Jaeschke, H., McGill, M. R., & Ramachandran, A. (2012). Oxidant stress, mitochondria, and cell
death mechanisms in drug-induced liver injury: lessons learned from acetaminophen
hepatotoxicity. Drug metabolism reviews, 44(1), 88-106.
McGill, M. R., Sharpe, M. R., Williams, C. D., Taha, M., Curry, S. C., & Jaeschke, H. (2012).
The mechanism underlying acetaminophen-induced hepatotoxicity in humans and mice
involves mitochondrial damage and nuclear DNA fragmentation. The Journal of clinical
investigation, 122(4), 1574-1583.
Schilling, A., Corey, R., Leonard, M., & Eghtesad, B. (2010). Acetaminophen: old drug, new
warnings. Cleveland Clinic journal of medicine, 77(1), 19-27.