Multiple Medication Management - Essay Example

Title: МULТIРLЕ МЕDIСАТIОN МАNАGЕМЕNТ Name Institution Name of the lecturer Dear Dr. Fisher, On the 15/02/15 I visited Mr. Johnson for home medicine review and these are the findings: Current Medication from Home Medicine Review Medication Dose Purpose DBL Aspirin 100mg 1 Mane Daonil 5mg 1 bd Esomeprazole 20mg 1 bd Natrilix SR 1.5mg 1 mane Simvastatin 20mg 1 daily Coversyl 10mg 1 daily Seretide MDI 250mcg/mcg 1 bd Temaze 10mg Once a week When having trouble with sleep Panadol Osteo 665mg Two tablets two times daily Panamax 500mg Two If he lacks sleep Glucosamine sulphate 500mg One or two regularly Fish oil 1000mg Every day Mobic 15mg Rarely When knees are paining Looking at the provision history and examination of Mr. Johnson, his medical management and concordance was good. Mr. Johnson has good understanding of his condition and medicine being prescribed by HMR and their purposes. Mr. Johnson demonstrated his knowledge about his prescriptions appropriately. After a comprehensive examination of his condition, Mr. Johnson was free to disclose other medicine as well as complementary therapies he is undergoing as far as his intervention is concerned. Along with, he provided how he uses other medicine to cure pain is various part of the body. He uses Mobic 15mg when knees are painful and Panamax 500mg to find sleep. He uses also Panadols 665mg 2 tablets twice a day as painkillers. The information I provided to Mr. Johnson: More exercises would reduce pressure in his stomach upon regular exercise, Having frequent meals rather than large meals at once would help Mr. Johnson condition. Not using extra pillows was highly recommended for him. Apart from fish oil, Mr. Johnson is advised to eat fish and lean meat rather than going for fatty or processed food. Also, Mr. Johnson is advised to eat a lot of fruit instead of junk food like biscuits and cares. Fruits increases the immunity of the body as far as Mr. Johnson health is concerned. On the case on Asthma management, Mr. Johnson was is advised to regularly going for check up to get specific needs for his condition. Though Mr. Johnson did not prompt on his medications during the time of interview, but the medication issues about his health needs to be considered. These medications include: Type 2 Diabetes: The results show that Mr. Johnson has an approximate HbA1c 7.2%. This result implies that he is suffering from diabetes of short duration which has no medical/clinical cardiovascular disease. As a result, the recommended therapy for this condition is modification of Mr. Johnson’s lifestyle. From the results, Mr Johnson has attained HbA1c 7.2% with total cholesterol level of 4.8mmol/L. Improve glucose regulation as well as weight loss. Regulation of insulin in the body system by use of placebo and empagliflozin (Draznin, 2011). The blood pressure of 140/85mmHg is high generally. This means that Mr. Johnson is at high risk of suffering stroke, heart failure or coronary diseases-heart disease. Simvastatin 20mg is recommended to be used daily by Mr. Johnson to control his blood pressure. It is very important if Mr. Johnson’s blood pressure is monitored and controlled in order to manage the cardiovascular risks (Taylor, 2011). With the cholesterol level at 4.8mmol/, this subjects Johnson of being affected severely by type 2 diabetes. As a result, it is recommended that cholesterol level being managed for the purpose of not leading to other health complications especially for those of hypertension (Thomas, 2013). Management of Hypertension: From the interview, Mr. Johnson provided some antidepressants he uses. For example, he uses Panamax to induce sleep when he lacks. This will interfere with the drugs prescribed hypertension. Looking also at the BMI of Mr. Johnson, this may not necessarily affect his high blood pressure. However, the high blood pressure he is suffering from perhaps is from stress and strain that comes to him at his old age as he says from the interview. The most evident aspect that may affects his blood pressure is the alcohol intake he does per week with his friends, if he can reduce the amount of alcohol intake to below 21 units per week, this could help him in a collaborative approach of managing his high blood pressure. Apart from fish oil he is taking every day, he should also add some portions of fruits at least five and vegetables in a day (Catheter-Based Renal Sympathetic Denervation for Resistant Hypertension: Durability of Blood Pressure Reduction Out to 24 Months, 2011). With the present of hypertension and lack of exercise may be contributing to cases of joint pains on the knees. Having physical activities be part of his daily life and limiting sedentary activities like staying in couch would help build up the joints. However, vigorous exercise is not considered for Mr. Johnson particularly when managing his high blood pressure situation (MacGregor and Kaplan, 2012). The major risk factor of hypertension is the type 2 diabetes Mr. Johnson is suffering from. Therefore, monitoring his blood level sugar will help in managing his high blood pressure. Asthma management: DBL Aspirin100mg and some of the anti-inflammatory drugs which include pain relievers Mr. Johnson is using contribute to asthma especially in the cold seasons. Consider referring him to allergy immunology clinic for him to get special and recommended drug for relieving pain. It is recommended that Mr. Johnson have inhaler during heavy cold season and always know the number of puffs he should take in case he experience asthma attack. Again, vigorous exercises that lead to fast breathing should be avoided by Mr. Johnson. Referral to physical exercise therapist is highly recommended considering the state of Mr. Johnson. During this process of therapy, the doctor should periodically record lungs function tests both peak flow and spirometry (Akrawi, 2014). This is appropriate since both measures how fast the lung can force out air and how much air the lungs can hold. I spoke with Mr. Johnson about coming up with action plan of managing asthma. I would also consider you talking with him on how to work out this action plan successfully. The plan will comprise of assessment and monitoring, controlling the risk factors that leads to severity of asthma in cold seasons, pharmacotherapy and health education on his condition (Dinakar et al., 2014). This plan is open for manipulation basing on the interest of the patient. The influencer vaccination introduced in 2014 for Mr. Johnson should continue and also integrated into the proposed plan. Also consider asking Mr. Johnson the kind of food he is clinically allergic to since this will be considered during asthma management process. Gastro-Oesophageal Reflux Disease: Alcohol use per week and food especially the spicy foods over the vacation holiday by Mr. Johnson maybe the contributing factors to GORD. Though inhaler has not been introduced for Johnson, this can act as a medical supplement that causes GORD. High fat diet is also evident from Johnson results and this may also contribute to risk of this condition. However, I couldn’t find overweight as being a problem that could have led to this condition. Therefore, taking fish oil every day may be excess for Johnson and it should be reduced. GORD for Johnson does not look chronic and therefore surgery should not be recommended for him unless when further examination calls for it. However, to improve the efficiency of management, H2 receptor antagonists may be recommended upon medical examination. Since in most cases, people with GORD may respond very well with medication during the initial stages of treatment but the symptoms can return again within few days or weeks (Granderath, Kamolz and Pointner, 2006). Therefore, Johnsons’ condition on GORD requires regular monitoring of medications on a long term basis. Educating Mr. Johnson for self-care initiative on GORD is highly recommended since the condition can unpredictably appear. Self-care would help him especially at severe instances of the condition. Hyperlipidaemia: The total cholesterol of Mr. Johnson is 4.8 mmol/L. This shows that he has less risk of hyperlipidaemia. However, increase in the intake of lipids, fish oil in this case would lead to shift of cholesterol level from 4.8 mmol/L to 7.8 mmol/L which will subject Johnson to high risk of hyperlipidaemia. First step in treatment is to reduce intake of fish oil in order to reduce lipid contents in the system. Secondly, small exercises are recommended just to nourish the tissues (Ito, McGowan and Moriarty, 2011). The patient did not show more features of this conditions but avoiding of fatty foods would reduce the risk of getting the condition. Thanks for referring Mr. Johnson for Home Medicine review. I am available if in case you call me to discuss all the recommendations with you. I am available through either my contacts or facility contacts. I will appreciate if you send me medication management plan copy that you came up with Mr. Johnson. Yours sincerely References Akrawi, D. (2014). Measures of Asthma Status: Need for Standardized Methodologies for Management. Munich: GRIN Verlag GmbH. Catheter-Based Renal Sympathetic Denervation for Resistant Hypertension: Durability of Blood Pressure Reduction Out to 24 Months. (2011). Hypertension, 57(5), pp.911-917. Dinakar, C., Oppenheimer, J., Portnoy, J., Bacharier, L., Li, J., Kercsmar, C., Bernstein, D., Blessing-Moore, J., Khan, D., Lang, D., Nicklas, R., Randolph, C., Schuller, D., Spector, S., Tilles, S. and Wallace, D. (2014). Management of acute loss of asthma control in the yellow zone: a practice parameter. Annals of Allergy, Asthma & Immunology, 113(2), pp.143-159. Draznin, B. (2011). Oxford American handbook of endocrinology and diabetes. New York: Oxford University Press. Granderath, F., Kamolz, T. and Pointner, R. (2006). Gastroesophageal reflux disease. Wien: Springer. Ito, M., McGowan, M. and Moriarty, P. (2011). Management of Familial Hypercholesterolemias in adult patients: Recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia. Journal of Clinical Lipidology, 5(3), pp.S38-S45. MacGregor, G. and Kaplan, N. (2012). Hypertension. Abingdon: Health Press. Taylor, R. (2011). Reversing type 2 diabetes. Practical Diabetes, 28(9), pp.377-378a. Thomas, M. (2013). Understanding type 2 diabetes. Wollombi, N.S.W.: Exisle Publishing. Read More