Question

M.J. is a 44-year-old female, who has been suffering from Renal Disease due to HTN for many years. She also has Type II Diabetes. She is currently taking Atenolol and Metformin.  She recently saw her cardiologist after a recent event of shortness of breath with increased distal edema.  Who at that time added Lasix to her prescribed regimen.  She presents today with fever and sinus congestion.  As her nurse, what medications would you expect the doctor to order for her and what considerations should be looked at with this client.  

1) What would be your main concerns, why?

2) What drug interactions if any could possible cause harm?  

3) What actions would you take?

4) What would you advise J.L. in regards to taking these medications?

Answer 1

In this case as the patient is having the HTN and the also the diabetes and she is currently taking Atenolol and Metformin. The patient feels shortness of breath with increased distal edema as the atenolol significantly decrease urinary excretion of metformin due to significant drug to drug interaction.

After this the Lasix i.e. Furesemide a loop diuretic was added in the regimen to overcome this distal edema. Then she feels fever and sinus congestion as the side effects concerned with this combinational therapy as this may cause the nasal irritation.

In this case once the drug interaction effects are observed then change the existing drug with the same category.

And patient should be educated regarding the common ADRs related with these medications.

Further we can take the combinational approach to take medicines in lower dose to reduce the toxicity.

Further the patient should be advised to maintain the fluid balance of the body and be on some regular exercise to reduce these HTN symptoms and manage the related side effects.