Allergic Rhinitis Case Study

In Japan, prices for every procedure and drug are negotiated every two years between the physicians and the government. The prices are fixed and the same regardless of where you go in Japan for treatment (Reid, 2008). In the United States, different healthcare plans offer a variety of coverage for medications but some prescriptions can be denied by the insurance company based on your type of insurance plan. Drug companies are very competitive in the United States and prices are expensive. Frequently, insurance companies might cover a similar or generic form of medication rather than the brand name medication and insurance co-pays differ depending on which drug is prescribed.

R.J. is a 15-year-old boy with a history of asthma diagnosed at age 8. His asthma episodes are triggered by exposure to cats and various plant pollens. He has been using his albuterol inhaler 10 to 12 times per day over the last 3 days and is continuing to wheeze. He normally needs his inhaler only occasionally (2 or 3 times per week). He takes no other medications and has no other known medical conditions. Physical examination reveals moderate respiratory distress with a respiratory rate of 32, oximetry 90%, peak expiratory flow rate (PEFR) 60% of predicted, and expiratory wheezing.

Prescription drugs all around are very expensive, but without out them some of us would not be able to say we are alive. We can still see the price of these prescription drugs go through the roof as we speak. Although most of low-income workers can barely afford medicine and drugs, one way or another, we make it work because without it we would be dead. Although having insurance covers a lot of our medical health expenses, such as medical bills, prescription bills, hospital bills and things of this nature. As the cost of prescriptions keep going up, sometimes our insurance companies cannot cover the cost because they have hit their Cap of money able to spend. Some insurance companies have Cap for a person or a cap for a whole family it can be yearly or annually it just depends on the “deal” you worked out with your insurance provider. Most families, like my own make due to cover the cost of having insurance, yet we have to still be able to cover what remains of the prescription cost if we want to live. Money sometimes is very tight and meeting these necessary financial situations get tough.

In the United States, health care price information is rarely made available to the health care consumer when they receive the service. Patients are usually become aware of the costs when they receive the bill. The price health care can vary radically by health care provider. Furthermore, prices can even vary by payer for the same provider. According to one study, consumers paid 10 to 17 percent less when they were given access to comparative price data. This tended to work best for consumers who had to pay for at least a portion of their care out of pocket. According to a paper that was published in the American Economic Journal: Economic Policy, when patients had access to price data and were willing to shop around, they could be paying significantly less for everything from routine screenings to knee surgery \cite{www-google-transparent}. This tended to work best for consumers who had to pay for at least some portion of their own care.

Pamela was seen today following her trial of Alvesco and her stress myocardial perfusion scan. Reassuringly, the stress myocardial perfusion scan was normal showing godd ventricular function and no obvious evidence of ischemic heart disease.

Nurses always play a vital role in patient safety and care. In contrast with the past, today the nurses are well-informed, with a focus on coordinating patient care and the use of critical-thinking skills. Being a significant health care professional involved in the patient care, nurses have several responsibilities such as preventing medication errors, ensuring the patients attain accurate treatment and above all upholding the patient safety. While coming to case management nurses, they need to have deeper understanding of healthcare services and their application. In addition, they must have enhanced organizational talent and effective communication skills with the patients and with different sources on behalf of these patients.

My son was born with a severe upper respiratory disease. He had to undergo several years of intensive treatment and on occasion, surgery from birth to 12 years of age.    Consequently, respiratory disease is an illness that affects everyone in our household to some degree. However, my son's battle with the disease was life threatening and his livelihood was seriously impacted by this disease.

I am also suspicious that she is struggling with eustachian tube dysfunction. We talked about treatments. We briefly discussed the idea of antibiotics, but at this point, my suspicion is this is still more viral. She is aware of what to be watching for and knows to call me if there is not improvement here through the course of the rest of the week or into early next week. We talked about good hand hygiene to avoid new illness or spread to others. One of her biggest complaints is just coughing at night and keeping her awake. I did write her for Tussionex cough syrup 5 mL twice daily p.r.n. four ounces with no refills. She is aware of side effects and is aware of sedation, in particular. She will not take it if she is driving or with any other sedating medication. She will monitor her symptoms, in the interim. She will continue with her Flonase and if there is no improvement here into next week or so, consideration for antibiotics can be done. If there is acute worsening in her respiratory status or other concerns, she will seek care if necessary and will otherwise follow up as needed with Dr. Lilly. All questions answered in the office

Healthcare payers (government and insurance agencies) are interested in opportunities that allow patients to do something more economically favorable for cost containment. Payers are also interested in cost effectiveness of the treatment, where questions

Shaun was seen today as ongoing management of his asthma with fixed airflow obstruction. Whilst he originally did very well coming off the Alvesco and continuing with the Seretide 250/25 two puffs twice a day, in the colder months, his asthma control has worsened and he is using Ventolin every other day multiple times throughout the day. He is also noticing some exercise limitation. Pleasingly, though, he is not having any nocturnal symptoms of asthma. There seems to be no other cause for his deterioration, in particular, he has no nasal or sinus symptoms and he has had no return of his GORD on his current Somac therapy. He has had issues before with his asthma and it is perhaps the cold air that is exacerbating his underlying airways

Drug-induced rhinitis is an excellent differential diagnosis. Mr. Jones may be suffering from allergies and could have had a reverse effect to his antihistamine medications. “Decongestant nasal sprays can help reduce nasal congestion when you have a cold. But after a few days, the lining of your nose may become less responsive to the medication” (“Avoid Rebound,” 2014). This causes the congestion to worsen. Relief comes when the patient stops using the medication. Patients may need a full explanation of this type of drug induced congestion as it may be confusing to them knowing that a medication may provide worsening effects. Using these nasal decongestants for “no more than a few days in a row” can help to minimize this side effect (“Avoid

The lack of sustained response to Alvesco would argue against the previous presumptive diagnosis of either cough variant asthma or eosinophilic bronchitis. To be completely sure of this, I will trial Ray on a course of a ten-day course of prednisolone and he will contact me thereafter. If there has been

The epidermis of the skin has the functions of immune nonspecific defense and water retention due to barrier qualities. Nonspecific defense is innate and defined by the fact that it does not differentiate between foreign matters; it protects against all external materials rapidly (Stanfield, 2013, p. 675). The stratum corneum is the tough superficial layer of the skin, which is bound by non-nucleated cells called corneocytes. Corneocytes are keratin bundles bound by proteins and lipids. Lipids are necessary for the skin to function as a barrier in order to maintain moisture levels in the skin (WHO, 2009). Chronic atopic dermatitis (AD) is an inherited genetic skin disease which typically begins in childhood and is characterized by dry, itchy, and inflamed skin. Genetic defects in the production of filaggrin are the basis of dry skin and a risk factor for developing AD. Histamines produce1 the sensation of itch and are released into the skin as an immune response, triggered by inflammation. AD creates inflammation in the skin by autoimmune abnormalities, even without the presence of a bacteria, virus, or irritant. This chronic disease may be controlled through medical treatment

This paper will review a case study of a 30-year-old patient who has been diagnosed with asthma and allergies. The patient was put on the medications; albuterol, (Proventil), salmeterol (Sere vent), and montelukast (Singular). The patient’s provider told the patient to come back in two weeks for follow- up. If at that time she is still wheezing, he would put her on an oral corticosteroid (Kelleher, Sheryl MS, CFNP, Class Assignment). This paper will define what asthma and its pathophysiology is, as well as review the patients prescribed medications of albuterol, salmeterol, and montelukast. Lastly, a review of corticosteroids and their adverse effects, dosing, and other implications will be discussed.

There are many kinds of allergies that people can have. One of the most common ones that affect many people every year is allergic rhinitis, which is more commonly known as hay fever. Allergic rhinitis is an allergy disorder that causes the immune system to overly react to pollen and other allergens (“Understanding Hay Fever -- the Basics.”). It also comes in two forms: seasonal and perennial. Seasonal allergic rhinitis usually occurs in one of the seasons, while perennial allergic rhinitis occurs during the whole entire year (“Allergic Rhinitis”). Allergic rhinitis is so common that 17.6 million adults in the United States were diagnosed in 2012 alone (“Allergy Statistics”).