Question

Polypharmacy in the Elderly R.М., a 77 year-old retired librarian, sees several physician specialists for a variety o problems. She uses the pharmacy at a large discount store but also has prescriptions filled at a nearby pharmacy, which she uses when she does not feel like going into the large store. Her medication list is as follows: Thiazide diuretic, prescribed for peripheral edema Potassium tablets, prescribed to prevent hypokalemia Beta-blocker, prescribed for hypertension Warfarin, taken every evening because of a history of deep vein thrombosis Thyroid replacement hormone because of a history of hypothyroidism Multivitamin tablet for seniors What medications may cause problems for R.M.? Explain What measures can be taken to reduce these problems? 1. 2. R.M. visits the pharmacy to pick up some medications for a cold. She has chosen a popular over-the-counter decongestant, an antihistamine preparation and a nonsteroidal anti- inflammatory drug for her "aches and pains". Should she use these medications? If not, what advice would you give to her about choosing over-the-counter medications? 3.

Answer 1

1.At the age of 77 the body's mechanism goes down and caution should be taken during medication intake

Thiazide diuretics has an effect of resulting in metabolic complications (severe electrolyte imbalances,glucose intolerance with lipid abnormality )In addition beta blocker is a chronotropic drug to heart leading to CHF.Warfarin being a blood thinner .Thyroid hormone replacement can give possible heart attack

2.Some of the measures to reduce the problems are

• Take medication as prescribed,avoid OTC medication
• Monitor blood pressure,pulse,weight chart,intake output
• Avoid injury to the body because this may result in bleeding
• No smoking or alcohol
• Check Sr.potassium level at regular interval

3.She cannot take a medication without doctors order.Taking decongestant or antihistamine can have drug- drug interaction between warfarin .Moreover taking NSAID can aggravate gastrointestinal symptoms because already warfarin has a tendency to cause peptic ulcer and increase the risk of bleeding .Also taking decongestant can increase the blood pressure