NU302 Unit 9 – Worksheet 2 Ms Davis is a 74 year old female and presents with th

Question

NU302 Unit 9 – Worksheet 2

Ms Davis is a 74 year old female and presents with this assessment data:

History:

Diabetes;

high blood pressure;

heart failure;

moderately severe kidney disease;

high cholesterol;

heartburn;

severe knee arthritis;

burning neuropathy in her feet;

glaucoma;

depression; and

insomnia.

Current medications:

Metformin 1000 mg 2 X daily;

Glipizide 5 mg daily;

Metoprolol 50 mg 2 X daily;

Lisinopril 40 mg daily;

Furosemide 20 mg 2 X daily;

Simvastatin 40 mg 2 X daily;

Amitriptyline 25 mg at bedtime;

Duloxetine 20 mg daily;

Clonazepam 0.5 mg 2 X daily;

Gabapentin 600 mg 3 X daily;

Ranitidine 150 mg 2 X daily;

Hydrocodone/Acetaminophen 5mg/325mg 4 X daily as needed;

Timolol 0.5% 1 drop to both eyes daily; and

(OTC) Diphenhydramine 25 mg at bedtime

Directions:

Answer the following questions and statements based on the case study presented.

1. Identify five physical changes in this older adult that could affect pharmacokinetics. Give a brief explanation of each change and provide rationales to support your ideas.

2. Using Beers criteria, list potentially inappropriate medications for this patient.

3. Discuss the potential risks of psychotropic drugs in the older adult.

Explanation / Answer

Pharmacokinetics is the what body does to the drug. In above mentioned patient below five physical change may alter pharmacokinetics of drug

1. Kidney failure

2. Heart failure

3. Depression

4. BP

5. Insomnia

Though upper are terms but they are directly related to the physical changes. Kidney is most important organ for the excretion of drug , here Davis suffered from kidney failure siento drug is not excreted properly may chances of double effect on body.

Heart is important organ for circulation of drug the whole body but here he suffered from heart disease and also BP die to which might be there no proper circulation of blood which will give no impact or late effect.

Depression and insomnia ia most important for drug effect , if you are well then drug effect is very well on your body but when you are psychological ill them might be there no effect of drug.

2. Inappropriate medications

He is too old hence never put him on dialysis because he don't have that power to digest dialysis

Take him away from injection and IV fluids of BP drug because it might give him lot of adverse drug reaction

He is patient of depression and insomnia hence change the drug every month to avoid addiction

3. Potential effect

Suicidal tendency

Vomiting and headache

Constipation

No food

Addiction

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