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Medication Management - Case Study Example

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It is important that cholesterol levels are monitored to ensure the need for continuous administration of Simvastatin with such high dosage. Decreasing level of cholesterol may indicate the need to decrease the dosage.
Multiple medications have great possibility of affecting the kidney and liver…
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Medication Management
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1. What further questions, if any, would you like to ask the doctor, and the patient Explain reasons for these questions. To the patient: Would she adhere with her son's suggestion to consult a naturopath
It must be considered that alternative medicine may also have adverse effect and contraindications, however they tend to present less due to lack of in-depth study with regards to their claim.
To the doctor:
What were the patient's past and current cholesterol levels
It is important that cholesterol levels are monitored to ensure the need for continuous administration of Simvastatin with such high dosage. Decreasing level of cholesterol may indicate the need to decrease the dosage.

Does the liver function being monitored
Multiple medications have great possibility of affecting the kidney and liver. The liver serves as the filter of these considerably foreign chemicals, if not toxic substance, incorporated in those long term medications.

2. Identify potential drug-related problems and suggest how these could be
addressed and/or monitored.
Due to the patient's age and complicated medical problems, the physician must be extra carefully with his prescriptions. Dr. Mack's prescription could have been helpful with regards to its aim to alleviate the problems; however, most of the prescribed drugs, despite its aim to cure one problem, tend to complicate the others.
The following conflicts were observed:
Simvastatin could aggravate muscle cramps which have been presented by the patient. Simvastatin aims to lower blood cholesterol, and since the referral does not clarify if it was monitored, I would suggest that it would be necessary to do so.
Aspirin could only be used to solve transient ischemic attack,
for the patient's worsening ischaemic heart disease, a maintenance drug such as Nifedifine (Calcigard) should be prescribed assured non-sensitive to it. However, blood pressure must be monitored because it is contraindicated to those with low systolic blood pressure. It should also be taken into consideration that Aspirin can worsen poor kidney function and breathing problems such as asthma. However, if the need for such drug persist, interic coated aspirin must be use instead; hence, the effect of Aspirin with regards, to her digestive problem (reflux) would be minimized.
Ditropan despite its aim to solve stress incontinence should not be administered to patients with untreated glaucoma. Moreover, the patient presents gastric reflux that needs extra caution upon use of such medication.
Seretide has been found to lower blood potassium level, thus monitoring of such blood electrolyte is necessary. This could be taken into serious consideration since low level of potassium would lead to sickening effect such as dizziness.
With the patient's low hemoglobin level, DiGesic must not be administered rather should be substituted with another drug of the same purpose.
3. Write a letter or report to the Doctor, outlining your key findings for this patient and your suggestions or recommendations to the prescriber.
Dear Dr. Mack,
With regards to your request for a review, I've looked at every detail of the Mrs. Bean's medical data and have tried my best to gather all medication possibility in lieu to your goal to improve her medical condition.
I've come up with the following observations/suggestions:
Simvastatin could aggravate muscle cramps which have been presented by the patient. Simvastatin aims to lower blood cholesterol, and since the referral does not clarify if it was monitored, I would suggest that it would be necessary to do so.
Aspirin could only be used to solve transient ischemic attack,
for the patient's worsening ischaemic heart disease, a maintenance drug such as Nifedifine (Calcigard) should be prescribed assured non-sensitive to it. However, blood pressure must be monitored because it is contraindicated to those with low systolic blood pressure. It should also be taken into consideration that Aspirin can worsen poor kidney function and breathing problems such as asthma. However, if the need for such drug persist, interic coated aspirin must be use instead; hence, the effect of Aspirin with regards, to her digestive problem (reflux) would be minimized.
Ditropan despite its aim to solve stress incontinence should not be administered to patient with untreated glaucoma. Moreover, the patient presents gastric reflux that needs extra caution upon use of such medication.
Seretide has been found to lower blood potassium level, thus monitoring of such blood electrolyte is necessary. This could be taken into serious consideration since low level of potassium would lead to sickening effect such as dizziness.
With the patient's low hemoglobin level, DiGesic must not be administered rather should be substituted with another drug of the same purpose.
Necessary to monitor liver function.
It would be best to advice the patient to refrain from driving and have someone to accompany her since most of her medications have inevitable side effects such as dizziness. In as much as any patient taking Toframil especially at her age, must always be supervised.
I hope this would help. I sincerely pray of Mrs. Bean's fast recovery in as much as you do. Thank you for your trust. I would be more than willing to serve you again in the future.
Kind regards,
Sources:
Ditropan. Drugs.com. Retrieved August 28, 2008 from: http://www.drugs.com/ditropan.html
Fosatran, 2005. MedicineNet.com. Retrieved August 28, 2008 from:
http://www.medicinenet.com/alendronate_70_mg_weekly-_oral_solution/page3.htm
Simvastatitn, 2006. MedicineNet.com. Retrieved August 28, 2008 from: http://www.medicinenet.com/simvastatin/article.htm
Sunthornsaj et al, 2005. MIMS 106th Edition 2005
Note: I failed to cite any source in the text since I've simply used what I've learned and remember from school. Nevertheless, I have manage to include reference that can confirm what I've wrote. I hope there wouldn't be any problem with that. Please inform me if ever there is. Read More
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