Read the following case study then:
* Identify and briefly discuss the pathophysiology of Rodney's medical condition.
* Describe the pharmodynamics of each of the drugs Rodney was prescribed linking this to the pathology.
* Justify the pharmacological regime, including choice of drug, changes to the regime, dosages and scheduling, and routes of administration.
* Critically discuss the mechanisms associated with resistance of either antibiotic OR antiviral drugs.
Rodney S was once a patient in a hospital in a major city of Australia. The records office of this hospital then suffered from accidental flooding due to a burst water pipe. Many records were damaged by the water, leaving much information irretrievable, including most of Rodney's clinical details.
Rodney has since died and his death has resulted in a coronial inquiry. The Coroner's Office has asked for Rodney's clinical records from the hospital, and the information that could be obtained from the waterlogged records is given below.
This refers mainly to the drug therapy used in the treatment of Rodney over the past two years and an occasional decipherable diagnosis. The drugs are listed in the order given from Rodney's initial admission date until his death.
12/11/99-14/02/00 Commenced zidovudine capsules 100 mg po q 5hr.
15/02/00-17/02/00 Zidovudine dose increased to 200 mg po q 4hr.
18/02/00-25/02/00 Cepacine (benzocaine and cetylpyridinium chloride) mouthwash prn q 12hr.
18/02/00-27/02/00 Zidovudine syrup 200 mg po q 4hr.
18/02/00-27/02/00 2 Amphotericin lozenges to be sucked slowly qid.
28/02/00 Zidovudine capsules 200 mg po q 4hr. Ketoconazole 200 mg d with food.
28/02/00-07/05/00 Ketoconazole shampoo. Twice weekly for 4 weeks.
15/04/00-01/06/00 Didanosine tablets 150 mg bd to be chewed.
02/06/00- Zalcitabine tablets 750 g tds.
02/06/00-14/06/00 2 cm 'Capsaicin' (0.075%) cream to painful area tds.
31/07/00- Protein purified derivative (PPD) skin test given which resulted...