Polypharmacy In The Patient Situation

Topic: OLDER ADULTT.M. is a 73-year-old woman who comes to a “brown bag” session at the local senior center. She reports recently feeling “sluggish” and dizzy. She lives at home alone on a modest, fixed retirement income. T.M.’s chronic medical problems include coronary artery disease (CAD), HF, hypertension, diabetes, and hyperlipidemia. She states that different specialists prescribe her “a lot of medications,” but she does not know their names.

She admits to skipping her medications periodically when she does not feel well. T.M. usually maintains an active social life, visiting her friends and attending the local seniors’ luncheons. She is interested in natural medicines and self-medicates with nonprescription medications and herbal remedies that her friends also take. Because of the recent weakness, however, she has not gone out as much.

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Review of her brown bag reveals the following items: glyburide 2.5 mg twice daily, hydrochlorothiazide 25 mg daily, atenolol 50 mg daily, ASA 325 mg as needed, digoxin 0.25 mg daily, nitroglycerin (NTG) 0.4 mg sublingual (SL) as needed, captopril 25 mg 3 times a day, furosemide 40 mg twice daily, acetaminophen 500 mg as needed, verapamil 60 mg 4 times a day, ibuprofen 200 mg as needed, and pioglitazone 30 mg daily.

She drinks a glass of red wine with dinner and Gold Seal Tea daily with lunch.  What initial steps are necessary for safe and effective management of T.M.’s drug therapy? Discuss each medication in the plan of care as it related to monitoring parameters, renal function and liver functions.Preparation of Case Study: See also https://en.wikipedia.org/wiki/Polypharmacy#:~:text=Polypharmacy%20is%20most%20commonly%20defined,two%20to%2011%20concurrent%20medications. for more details.

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1.  Make a summary of each medication taken by the patient: Name, Classification, Therapeutic  Dosage  Range,  Monitoring,  Parameters,  Adverse  Effects.,  Side Effects.

2.  Explain the absorption, metabolism, distribution and excretion of each drug.

3.  Identify if EACH drug has a wide or narrow therapeutic window. Explain why this important.

4.  State the therapeutic index of each drug, if available.
5.  Identify if each drug is strong or weakly bound to protein. Explain why this is important.

6.  Which cytochrome system do any of these drugs utilize? What is the significance?

7.  Benefits of each drug in relation to her medical conditions

8.  Patient teaching for each drug (1-2 interventions/drug) Be specific.

9.  Provide the rationale for your decision based on evidence-based research. (3 sources)10.After you have completed the answers to questions 1-9, formulate using a SBAR, the issues in your plan of care to follow up with when you see the patient in 2 weeks.

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