Pharmacology Discussion
Week 1
Professor and Class,
1. Introduce yourself to your instructor and the rest of the class.
Hello, I am Brandie Ingram and I live in San Antonio, Tx. I am 35 years old and married since
2008. We have 3 children ages 5, 6 and 10. We enjoy going to SeaWorld, hanging out at home,
gardening, swimming, and camping!
2. Tell us about yourself and your personal interests.
I have been a nurse since 2008 and prior to that I was an aide since 2003 for the same hospital I
am currently working in. I have worked on many different floors including med/surg, tele, oncology, ER
holds, and rehab. In 2011, I changed to prn status after having my son and have been prn/contract
since then. I float from floor to floor everyday but stay within the same hospital. This has given me a
wide range of skills.
3. Why did you choose to be a Nurse Practitioner?
I chose to become a Nurse Practitioner because I felt it was time to increase my responsibility
as a healthcare professional. After being a floor nurse for many years, I needed a change and thought
that this was a great way to stay in healthcare but also care for my patients in a more productive way. I
am hoping to work in a clinic where I see the same patients routinely and get to know each and every
one of them on a more personal basis. As a nurse in the hospital, we only know our patients for a few
short hours or days. Having a good line of communication and a trusting relationship with my patients
is a goal that I will accomplish.
4. What are your feelings about prescribing medications in your new role?
Currently, the thought of prescribing medications is extremely frightening but also exciting at
the same time. Prescribing the wrong medication can be life threatening but at the same time,
prescribing the right medication can be lifesaving. As I continue on my path of learning to become an
NP, I am hoping I will become more comfortable and confident with the idea of prescribing
medications.
WEEK 1 DISCUSSION
In your initial post, respond to the following scenario (Hint: use the pharmgkb website to guide
your responses):
, 1. Before initiating abacavir, an anti-retroviral, for a newly diagnosed HIV positive patient
the nurse practitioner orders HLA-B*5701 allele genetic testing. The test confirms that the
patient carries the HLA-B*5701 allele.
a. Describe what these results mean.
The HLA-B gene can be detected through either blood or saliva. The HLA-B gene has
an effect on how the immune system responds and recognizes various pathogens while
mediating hypersensitivity reactions (Faruki et al., 2017).This means that the positive result
indicated the patient has at least one copy of the HLA-B 5701 allele. As a carrier, the patient
has the potential to have severe side effects if given the antiviral medication abacavir.
b. Should the nurse practitioner prescribe abacavir in this case? If not, state why.
Since the patient is positive and is a carrier of the HLA-B 5701 allele, the patient
should not be prescribed abacavir. If prescribed, the patient could develop a hypersensitive
reaction causing rash, fever, vomiting, shortness of breath, and even death. Before any
healthcare professional prescribes this medication, a screening should be done to check for
the HLA-B 5701 gene.
2. A patient is prescribed antiplatelet therapy (clopidogrel) following an acute myocardial
infarction (MI). Six months later, the patient suffers another acute MI. The patient has been
adherent to therapy and the nurse practitioner suspects that clopidogrel may have been
ineffective. How might genetic testing have been beneficial in this case?
Clopidogrel (Plavix) is an antiplatelet drug that stops the ability of platelets from
sticking together and forming clots. According to Damman et al., 2017 genetic testing and
screening patients for the CYP2C19 allele can make a significant difference in the positive
health outcomes of ACS (acute coronary syndrome) or after PCI (percutaneous coronary
intervention) patients. Patients screened and found to have a loss of function in the CYP2C19
allele endure more ischemic events compared to patients without this dysfunction due to the
inability of clopidogrel being able to convert to its active form (Damman et al., 2017).
Ultimately, patients who are screened for the specific allele CYP2C19 and found to have the
loss of function can be prescribed other antiplatelet medication and prevent further
complications in the future.
3. Identify 2 limitations of pharmacogenomics testing. Explain.
According to Krebs & Milani, 2019 two limitations of pharmacogenetics are the lack of
genetic screening knowledge and cost-effectiveness evidence. Healthcare professionals
who prescribe certain medications should be knowledgeable in genetic testing to make
sure the medications prescribed are even effective. Krebs & Milani, 2019 explains that
healthcare providers who began practicing greater than ten years ago, have very limited
understanding, training, and/or knowledge of the different types of genetic screenings
Week 1
Professor and Class,
1. Introduce yourself to your instructor and the rest of the class.
Hello, I am Brandie Ingram and I live in San Antonio, Tx. I am 35 years old and married since
2008. We have 3 children ages 5, 6 and 10. We enjoy going to SeaWorld, hanging out at home,
gardening, swimming, and camping!
2. Tell us about yourself and your personal interests.
I have been a nurse since 2008 and prior to that I was an aide since 2003 for the same hospital I
am currently working in. I have worked on many different floors including med/surg, tele, oncology, ER
holds, and rehab. In 2011, I changed to prn status after having my son and have been prn/contract
since then. I float from floor to floor everyday but stay within the same hospital. This has given me a
wide range of skills.
3. Why did you choose to be a Nurse Practitioner?
I chose to become a Nurse Practitioner because I felt it was time to increase my responsibility
as a healthcare professional. After being a floor nurse for many years, I needed a change and thought
that this was a great way to stay in healthcare but also care for my patients in a more productive way. I
am hoping to work in a clinic where I see the same patients routinely and get to know each and every
one of them on a more personal basis. As a nurse in the hospital, we only know our patients for a few
short hours or days. Having a good line of communication and a trusting relationship with my patients
is a goal that I will accomplish.
4. What are your feelings about prescribing medications in your new role?
Currently, the thought of prescribing medications is extremely frightening but also exciting at
the same time. Prescribing the wrong medication can be life threatening but at the same time,
prescribing the right medication can be lifesaving. As I continue on my path of learning to become an
NP, I am hoping I will become more comfortable and confident with the idea of prescribing
medications.
WEEK 1 DISCUSSION
In your initial post, respond to the following scenario (Hint: use the pharmgkb website to guide
your responses):
, 1. Before initiating abacavir, an anti-retroviral, for a newly diagnosed HIV positive patient
the nurse practitioner orders HLA-B*5701 allele genetic testing. The test confirms that the
patient carries the HLA-B*5701 allele.
a. Describe what these results mean.
The HLA-B gene can be detected through either blood or saliva. The HLA-B gene has
an effect on how the immune system responds and recognizes various pathogens while
mediating hypersensitivity reactions (Faruki et al., 2017).This means that the positive result
indicated the patient has at least one copy of the HLA-B 5701 allele. As a carrier, the patient
has the potential to have severe side effects if given the antiviral medication abacavir.
b. Should the nurse practitioner prescribe abacavir in this case? If not, state why.
Since the patient is positive and is a carrier of the HLA-B 5701 allele, the patient
should not be prescribed abacavir. If prescribed, the patient could develop a hypersensitive
reaction causing rash, fever, vomiting, shortness of breath, and even death. Before any
healthcare professional prescribes this medication, a screening should be done to check for
the HLA-B 5701 gene.
2. A patient is prescribed antiplatelet therapy (clopidogrel) following an acute myocardial
infarction (MI). Six months later, the patient suffers another acute MI. The patient has been
adherent to therapy and the nurse practitioner suspects that clopidogrel may have been
ineffective. How might genetic testing have been beneficial in this case?
Clopidogrel (Plavix) is an antiplatelet drug that stops the ability of platelets from
sticking together and forming clots. According to Damman et al., 2017 genetic testing and
screening patients for the CYP2C19 allele can make a significant difference in the positive
health outcomes of ACS (acute coronary syndrome) or after PCI (percutaneous coronary
intervention) patients. Patients screened and found to have a loss of function in the CYP2C19
allele endure more ischemic events compared to patients without this dysfunction due to the
inability of clopidogrel being able to convert to its active form (Damman et al., 2017).
Ultimately, patients who are screened for the specific allele CYP2C19 and found to have the
loss of function can be prescribed other antiplatelet medication and prevent further
complications in the future.
3. Identify 2 limitations of pharmacogenomics testing. Explain.
According to Krebs & Milani, 2019 two limitations of pharmacogenetics are the lack of
genetic screening knowledge and cost-effectiveness evidence. Healthcare professionals
who prescribe certain medications should be knowledgeable in genetic testing to make
sure the medications prescribed are even effective. Krebs & Milani, 2019 explains that
healthcare providers who began practicing greater than ten years ago, have very limited
understanding, training, and/or knowledge of the different types of genetic screenings
