Question

Mr. Jones is a retired 84 year-old farmer. He is still living in the farmhouse, but rents the farm land. He has an 8th grade education. He is recently widowed, living alone, and adjusting to managing his health care on his own since his wife passed away. One area of concern is his medication management since he is taking 10 different prescription medications plus his 6 nonprescription medications. Mr. Jones is currently taking:

Ferrous sulfate 240 mg daily for anemia Protonix 20 mg daily for GERD Tums 1-2 tabs PRN for GERD Flomax 0.4 mg daily for BPH Restoril 15 mg as needed for sleep Aspirin 81 mg daily for his heart Lasix 40 mg daily for HTN KCl 10 mEq daily for hypokalemia Lisinopril 20 mg daily for HTN Metoprolol 100 mg BID for HTN Digoxin 125 mcg daily for A. Fib Coumadin 4 mg on M/W/F and 5 mg on all other days for A. Fib Nitroglycerin 0.3 mg q5 minutes PRN for angina Acetaminophen 325 mg PRN for pain Ginkgo Biloba 2 capsules daily for memory St. John’s wort 1 capsule daily for anxiety

Answer these questions

Do any of these medications interact with each other? If so, which?

What effects can caffeine, nicotine, alcohol, or other nutrients have on the specific medications that Mr. Jones is taking?

How can age-related changes affect his medication effectiveness?

What other information would you like to know to ensure medication safety?

Answer 1

1 yes ,one of the main drug ie Potassium chloride do interact with almost all of the medications

2 Though most of the diseases Mr Jones has is manageble.Yet it becomes life threatening when certain drugs are used in conjunction with caffeine ,alcohol and nicotine.Furthermore its been reported that poor diet through adulthood have been labelled as one of the primary causes of getting inflicted with such diseases.Drinking alcohol results in lowering the blood glucose level.Use of this drugs may result in abnormal heart rate and rythm maintained on anti-arrhythmia medications.Smoking increases vascular complications .Numerous drug interactions occurs with smoking.Therefore smokers taking a medication that interacts with smoking may require higher dosages than nonsmokers.Upon smoking cessation ,smokers may require a reduction in the dosage of an interacting medication

3 As age advances our regulatory process get impaired. Ageing is a period characterizedby structural and functional changes.The systemic clearance of digoxin also changes with age.The reduced haemostaticability affects different regulatory systems in different subject.Pharmacokinetic changes include a reduction in renal and hepatic clearance and an increase in volume of distribution of lipid soluble drugs.

4 inorder to ensure medication safety ask the health care practicioner about the serious drug interactions with the medications which the patient is taking.Check with the health care practicioner about the serious drug interactions with the medications he is taking.