What changes to eye structures are associated with prostaglandin analogue therapy? Are these changes harmful to the eye?

CASE STUDY (Total 20 marks)

Adapted from p 1120 6th Ed. Bullock & Manias

Ms PB is a 81-year-old widow living at home independently. Her ongoing health problems are:

chronic asthma, hypertension, peripheral oedema and angina pectoris, but she is managing them well using a combination of drugs and sensible lifestyle. The drugs she is taking for her condition are:

  • for asthma – the inhaled corticosteroid beclomethasone (daily); the inhaled asthma prophylactic sodium cromoglycate (daily); the inhaled β2 agonist salbutamol (as required)
  • for hypertension – the thiazide diuretic hydrochlorothiazide (daily); the α-antagonist prazosin (daily)
  • for angina pectoris – the peripheral vasodilator glyceryl trinitrate (as required)

Over the past few years her intraocular pressure has been rising and she has recently been diagnosed with open-angle glaucoma. She is prescribed the β-blocker betaxolol, the prostaglandin analogue latanoprost, and the muscarinic agonist pilocarpine, and has just had them delivered by her local pharmacy. You watch her instil the drops and offer her encouragement and advice about the correct use of these drugs. Within a couple of months of starting therapy her intraocular pressure is rechecked and found to be reduced.

Answer the following questions:

  1. By which route would the β-blocker, the prostaglandin analogue and muscarinic agonist be administered in the treatment of TH’s glaucoma? Why? (2 marks)
  2. Explain how each of the drug groups used to treat her glaucoma relieve the high intraocular pressure. You must cover the pharmacological mechanisms. (6 marks)
  1. How can systemic absorption of these drugs be minimised? (2 marks)
  2. What are the common local adverse reactions associated with topical administration of eye drops? (2 marks)
  3. Given PB’s pre-existing health problems, are there likely to be any precautions associated with her prescribed glaucoma therapy? (2 marks)
  1. Are there any potential drug interactions between her existing therapy and her glaucoma therapy worth noting? (2 marks)
  1. What changes to eye structures are associated with prostaglandin analogue therapy? Are these changes harmful to the eye? (2 marks)
  2. What advice would you give her regarding the adverse effects she might expect when using the β-blocker and the muscarinic agonist? (2 marks)

Use your text book and other references to answer these questions.

Create a proposal providing a recommendation for the types of treatment modalities to be utilized in the facility.

The local correctional facility is planning to implement a new treatment program for substance abuse treatment. You are hired to create a proposal providing a recommendation for the types of treatment modalities to be utilized in the facility. Use at least two peer reviewed articles from publications from a government website on substance abuse treatment to develop the proposal. Your paper should address the following:
• A discussion of the variety of substance addictions needing to be addressed in the treatment program in a correctional system, and your analysis for whether you would propose separating the inmates in treatment based upon the type of substance they use.
• A thorough comparison of individual treatment and group treatment, and your analysis for whether you would recommend individual treatment or group treatment, or both.
• A description of the12 step program, and your analysis for whether you would propose this be a part of the treatment program. 
• A discussion of the role of the family and incorporating the family within the treatment process, and your analysis of whether you would recommend family therapy to be a part of the treatment program.

Counselling & Psychotherapy

This question requires you to apply the framework developed by Corey (2005) to a fictional case, using a person-centred framework. For the purposes of this assignment, you are to choose one of the characters in the movie below and adapt the client’s role to meet the requirements of the assignment:
American Beauty (1999) movie, directed by Sam Mendes and starring Kevin Spacey as Lester Burnham, an office worker who has a midlife crisis when he becomes infatuated with his teenage daughter’s best friend. If you choose option 1, you can pretend that any member of the Burnham family has been referred to you for counselling by their GP:
· Dad ‘Lester’ (Kevin Spacey)
· Mom ‘Carolyn’ (Annette Bening)
· Daughter ‘Jane’ (Thora Birch)
The framework for your case study should include the following:
· An introduction to the client you have chosen
· Your basic assumptions about using a person-centred approach for this particular fictional client
· Your ‘assessment’ or understanding of the case from a person-centred perspective
· The goal(s) of therapy with this client
· A description of fictional key moments of the therapeutic process, preferably demonstrated with the use of ‘verbatim’ interaction between therapist and client.
Refer to Module 5 for an outline of Corey’s (2005) framework (Ch 1 & 5 of Case Approach to Counselling & Psychotherapy) and the example of “Ruth” to guide you on how to approach this case study assignment. When writing up a case study, you may use a loose report structure with decimal notation, or an essay structure with headings. However, full sentences and descriptive prose is required, not dot points or lists. In text and end text referencing are both essential for academic work.
Suggested length:
Maximum 2,500 words (excluding references) Penalty for word count 10% above applies. Please record your word final count (excluding reference list & cover page) on the cover page.
Assignment Presentation & Submission

Existential Counselling

COUN1921 Existential Counselling
x Unit Overview
Assignment 2
Assignment Type Weighting Word Count Week Due
Essay: Analysis of
Existential Therapy
Session
50 1500 11
Students will select and watch a 30-minute segment from one of the following videos in
the library In Video Collection:
· Existential-Humanistic psychotherapy in action Part 2
· Existential psychotherapy
Take notes during the session on any effective or ineffective interventions, congruence
with the existential model, client responses, and the quality of the therapeutic alliance
established by the counsellor.
Write an essay evaluating the application of the existential approach in the session,
providing verbatim examples from the session. Academic references must be used to
support the evaluation.
Your analysis is to include:
· description and analysis of interventions, and evidence of how they were effective
or ineffective in this instance, including verbal and nonverbal client responses
· discussion of how the therapeutic work demonstrates or fails to demonstrate
congruence with the existential model
· verbatim examples from the session to illustrate the points above
· evaluation of the quality of the therapeutic relationship including how it manifests
in this session
· analysis of the strengths and weaknesses of the approach as applied in this session
· a discussion of any identified ethical and professional matters for consideration
· reference to relevant literature, linking analysis of the session to theory discussed in
the unit
· a reference list with at least ten relevant references