A 78-year-old woman comes to the clinic for a new-patient examination. She reports that she smokes Cannabis several...
A 78-year-old woman comes to the clinic for a
new-patient examination. She reports that she
smokes Cannabis several times a week and also takes
alprazolam 0.5 mg three times per day, a combination tablet of
metoprolol tartrate 50 mg/hydrochlorothiazide 25 mg daily, aspirin
81 mg daily; garlic soft-gels 1000 mg twice a day; and ibuprofen
400 mg four times a day.
1. Do any of these drugs appear on the 2015 American
Geriatrics Society Beers Criteria for Potentially Inappropriate
Medication Use in Older Adults? If so, what do the criteria say
about them?
2. What interactions exist among the drugs and
supplements this patient is taking?
3. What is the evidence for taking garlic to reduce
cholesterol?
Homework Answers
1. Alprazolam - Older adults have increased sensitivity to benzodiazepines and decreased metabolism of long-acting agents; in general, all benzodiazepines increase risk of cognitive impairment, delirium, falls, fractures, and motor vehicle crashes in older adults.
Aspirin and Ibuprofen - Increased risk of gastrointestinal bleeding or peptic ulcer disease in high-risk groups, including those aged >75
2. Garlic products have been reported to cause bleeding in rare cases, and taking it with other medications that can also cause bleeding such as aspirin may increase that risk.
3. It's important to note that the studies are very conflicting. While there are many that conclude garlic works well to lower cholesterol levels 1or 1.5gm of garlic is all needed to reduce the cholesterol . On the others hand that dispute this, contending garlic is ineffective in lowering cholesterol. Until more studies are conducted, garlic may not be the best choice for solely relying on it to lower the cholesterol.
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A 78-year-old woman comes to the clinic for a
new-patient examination. She reports that she
smokes Cannabis several...
A 78-year-old woman comes to the clinic for a new-patient examination. She reports that she smokes Cannabis several...
A 78-year-old woman comes to the clinic for a new-patient examination. She reports that she smokes Cannabis several times a week and also takes alprazolam 0.5 mg three times per day, a combination tablet of metoprolol tartrate 50 mg/hydrochlorothiazide 25 mg daily, aspirin 81 mg daily; garlic soft-gels 1000 mg twice a day; and ibuprofen 400 mg four times a day. 1. Do any of these drugs appear on the 2015 American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in...
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After reviewing the patient information, what are your
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Diagnosis Atrial Fibrillation (new onset) HF, HTN, Glaucoma 128/76 90 (irregular)-20 98.4F and 98% Weight (Baseline): 146 PMH Vital Signs Current Hospital Assessment data shared with the primary care provider Lung clear Renal function within normal. She went to the Emergency Department with complaints of Shortness of Breath (SOB), palpitations, fatigue and feeling anxious. She was admitted for two days and diagnosed with new...
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