The article I chose “The Ethics of Managing Recurrent Respiratory Papillomatosis in Children: A Case
Study.” Discusses the use of off label medications to treat children with rare recurring medical
Illnesses and the ethical decisions that healthcare providers face in using them. Off label medications are those described as being used in a manner which is either not specified in the medication insert or is not an accepted standard treatment. Within this case study there are three off label medications used, they are Gardasil, the quadrivalent HPV vaccine for HPV stereotypes 6,11,16,18 and
Propranolol a beta blocker. The case study presents a three year old Malay boy who presented with stridor and hoarseness lasting approximately a week.
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It was during this procedure that multiple papillomatosis warts were seen on the vocal cords and in the Surrounding tissues. Further examinations confirmed the diagnosis of laryngeal papillomatosis. This rare disease is caused by the human papillomavirus, or (HPV) infection in the throat. It causes tumors to develop over a period of time in the throat and has the potential to be fatal as the growths can obstruct the airway. Surgical micro-debridement was done for the patient and resulted in favorable results of the stridor during post op. The patient experienced several recurrences and required that the patient undergo several surgical procedures. Eventually the patient was referred to a Pediatric team to possibly undergo therapy using an off label medication. In this case, Gardasil being one of them and the other being propranolol. Both which had trialed very poorly in clinical trials. The article discusses the ethics behind rather or not the patient should have been given to this young Patient when the in trials these medications didn’t perform very well. As well as the criteria, individual and ethical decisions that have to be made on a case by case basis amongst a team of medical providers. Prior
This paper will demonstrate the author’s ability to prescribe safely from the Nurse Prescribing Formulary (NPF 2009-2011). A prescribing situation undertaken by myself while supervised by my mentor will be discussed. The patients name, address, date of birth and GP details have been changed to ensure patient confidentiality in accordance with the Nursing and Midwifery Council (NMC)(2004). The patient therefore will be referred to under the pseudonym Prince Charming.
The dosage was to high for the patient because the chart started going over the regular normal level
All three providers have agreed that prescribing a pharmacologic and non-pharmacologic treatment regimen must result from clinical judgment based on a thorough assessment of the patient and the patient’s environment, present and past medical history, current home medication, the determination of differential diagnosis and appropriate diagnostic procedure, a review of potential alternative therapies and specific knowledge about the drug chosen and the disease process it is designed to treat (Woo & Robinson, 2016; p.6).
List one or two adverse reactions for the selected agent(s) that would cause you to change therapy.
Pediatric patients specifically have a propensity to be exceptionally soft to most medications, from this time they need to figure the bigger percentage of their pharmaceutical doses by weight. The minimum erroneous conclusion could prompt an unfriendly medication impact. More grown-up this is including the elderly, then again, are limited to, numerous doctor prescribed medications for their endless sicknesses which require examination to hold away from contraindications. On the other hand, paying little mind to whether the patient might be at danger of encountering a pharmaceutical mistake or not, all drug organizations should in a perfect world take after the "seven rights" which incorporate "the right patient, right prescription, right measurement, opportune time, right course, right reason, and right documentation". (Bonsall,
The patient conducted her consulattion with her Medical Doctor of the clinic and is aware why her dose decrease will not get approved. The patent then reported, she will attempt to improve on her discontinuing her illicit use.
Drugs are used in these cases but the results are not always fortunate. Though the vast majority of drugs are used to treat medical conditions, there are also the few
The patient is upset that his dose was decrease and at first, struggled with the
*Used patient history and exam results to make decisions on the treatment protocol appropriate for that individual
D-The patient was placed on HOLD due to her missing counseling session on Monday. Please note, the patient reported that she is stable on her dose and has no desire of decreasing or increasing her dose when offered by this writer. At first the patient was venting about wanting to leave CSAC as she appeared to be waiting too long to get dose. This writer advise the patient about patience as a virtue as each Nurse as to assess every patient that approach the dosing window.
Human Papillomavirus (HPV) is a sexually transmitted virus that spreads from person to person by direct contact of infected tissue. According to the CDC, nearly all men and women will contract HPV at some point in their life (Centers for Disease Control and Prevention [CDC], 2013). HPV can cause cervical, vaginal and vulvar cancers in females. HPV can also cause anal, throat, and neck cancer in both males and females. HPV is also known to cause genital warts in both males and females. According to the National Cancer Institute (2013), “approximately 12,340 new cases of cervical cancer will be diagnosed in the US, and 4,030 US women will die
Patients must be provided with adequate information for them to make an informed decision. The clinician must explain.
Human Papilloma Virus, or HPV, is an infection that commonly causes warts. They can appear on the feet like plantar warts or on the face or neck. Although there are over 100 varieties of HPV, some can cause cancer but most do not. Cancer of the cervix, anus, penis, vagina and back of throat are also some cancers attributed to HPV.
Human papillomavirus is an infection that comes in many different varieties. There are over a 100 varieties of the infection. It was first identified in 1956 by a team of scientists. The virus can range in severity between sub-clinical, up to cancerous. The infection itself is not a cancer but may lead to cancer. Many individuals may not even know that they have HPV.
Human Papilloma Virus (HPV). HPV infection Is a sexually transmitted disease (STD) caused by 30 to 40 of 130 or so strains of Human Papilloma Virus.