Daute is a 56-year-old man seeking evaluation for increasing shortness of breath

Daute is a 56-year-old man seeking evaluation for increasing shortness of breath. He noticed difficulty catching his breath about 3 years ago. Physical activity increases his symptoms. He avoids activity as much as possible to prevent any SOB. His previous physician had placed him on salmeterol/fluticasone (Advair Diskus) one inhalation twice daily 2 years ago. He thinks his physician initiated the medication for the shortness of breath, but he is not entirely sure. He did not refill the prescription and has not been taking it. Pertinent history – Chronic bronchitis X 8 years with one exacerbation in last 12 months of treatment with oral antibiotics. He has a 40-pack-year smoking history. What treatment plan would you implement for this patient? What medication(s) would you prescribe? How would you monitor the effectiveness of this plan?

To Prepare:

· Review the case studies (attachment) and answer ALL questions.

· When recommending medications, write out a  complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications.

· Use clinical practice guidelines in developing your answers. Please review all Required Learning Resources. Use the Medscape app or website and JNC 8 to complete assignment.

· Include  at least three references to support  each scenario and cite them in APA format. Please include in-text citations. You do not need an introduction or conclusion paragraph.