Provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.

The patient that I have is a 46-year-old female who is 230 pounds and has a history of breast cancer. Patient is up to date on her yearly mammograms and has a history of hypertension. Patient complains of night sweats, hot flashes, and genitourinary symptoms. Patient also has a history of ASCUS about 5 years ago on pap smear, but all other pap smears have been normal. Patient has regular menstrual cycles, states that last one was 1 month ago. Patient currently takes Amlodipine (Norvasc) 10mg PO daily and Hydrochlorothiazide (Microzide) 25mg PO daily. Patients’ blood pressure today is 150/90. In this case study, I feel like this patient is experiencing symptoms of perimenopause. The patients’ healthcare needs include hypertension management, yearly pap smears because of her history of ASCUS, yearly mammograms due to family history of breast cancer, and weight management. To better manage the patients’ blood pressure, I would discontinue the Amlodipine (Norvasc) 10mg PO daily and start Lisinopril 20mg PO daily for hypertension. With discontinuing the Amlodipine (Norvasc) 10mg PO daily this might would help stop the hot flushing. With taking Amlodipine (Norvasc), researchers observed edema, dizziness, flushing, and palpitations in controlled clinical trials in a dose-dependent manner (Bulsara & Cassagnol, 2022). With starting patient on Lisinopril 20mg PO daily, I would have the patient record her blood pressure in the morning and at bedtime for 2 weeks and then follow up with her to see how her blood pressure is running. If the patients’ blood pressure was controlled, I would discontinue the Hydrochlorothiazide (Microzide) 25mg PO daily and see how the patient done for 2 more weeks with just the Lisinopril 20mg PO daily. If the patients’ blood pressure was controlled with just the Lisinopril 20mg PO daily and I could discontinue the Hydrochlorothiazide (Microzide) this would help alleviate some of the genitourinary problems that the patient is having. I would consider a Hormone Replacement Therapy due to patient being perimenopause. Hormone replacement therapy (HRT) can help balance estrogen and progesterone levels during or near menopause (“Hormone replacement therapy: Uses, types, and alternatives”). HRT can help relieve hot flushing and night sweats. Before prescribing any Hormone Replacement Therapy I would order some blood work to check the patients’ levels before initiating HRT. I would educate the patient on the importance of getting yearly mammograms due to her family history of breast cancer and HRT could increase the risk of breast cancer as well. I would also educate the patient on the importance of getting yearly pap smears due to a history of ASCUS. Patient education would include education on the side effects of lisinopril include feeling tired, feeling dizzy or lightheaded, cloudy urine, decrease in urine output, confusion, blurred vision, and sweating (“Lisinopril (oral route) side effects”). Also, I would educate the patient on the importance of knowing how to recognize signs and symptoms of hypotension. I would educate the patient on weight management techniques and would also recommend some exercise regimens due to the patient being overweight. During the patient’s weight loss, her blood pressure will need to be monitored closely so hypotension can be avoided.

 

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.

God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.