What Are the Findings Following Reviewing This Medication List?
A 45-year-old woman presents to a clinic with back pain as the main complaint and describes it as her chronic condition that she has had during the last ten years. The patient states that she “is just not feeling good.” The reasons for such a conclusion can be a list of medications she takes at the moment of the visit. As soon as she started her workout, she was suggested to use Creatine and Coenzyme Q10 to achieve successful results in building muscles. In addition, she takes Kava Kava regularly. She also takes Glyburide 3 mg daily to control her type 2 diabetes, Lisinopril 20 mg to treat her hypertension, and Coumadin 6 mg to prevent her recurrent DVT.
The impact of the chosen medications on the patient’s condition (diabetes) should be discussed. Creatine and Coenzyme Q10 are the pre-workout supplements and antioxidants that may have the components which increase blood flow and influence heart rate. Diabetic patients should consult a doctor before taking them together with such drugs as Glyburide and Coumadin because of the possible risks of hypoglycemia, decreased levels of creatinine, and the neuroprotective effect (Zhang et al., 2016). The main feature of people who have diabetes is high blood sugar levels (Pradeep & Haranath, 2014). Coenzyme Q10 and Creatine may cause a decrease in the blood sugar level that is not inherent and rather dangerous for diabetic people.
In addition, Creatine may cause an increase in blood pressure among patients who suffer from hypertension. It can be hard to control blood pressure when an antidiabetic drug is used with an antioxidant. Blood pressure increase has a negative impact on vein conditions. Therefore, the blood-thinning properties of Coumadin can be dramatically decreased because of Coenzyme Q10 and provoke the returning of DVT.
Finally, a combination of Creatine and Lisinopril deserves attention because such conditions as hypertension and diabetes associated with back pain may signalize that the patient has kidney problems. Diabetic medications and angiotensin-converting enzyme inhibitors like Lisinopril may contribute to the development of chronic kidney disease (Hall et al., 2014). Sometimes, people are not able to distinguish between back pain and kidney problems. Therefore, this side effect can be the one that actually bothers the patient.
Is There Additional Information You Would Obtain?
Taking into consideration a number of physical and pharmacological changes in the patient’s life, some additional information has to be obtained to make sure that all processes work well and all patient’s reactions meet expectations. First, it is necessary to pay attention to family history and clarify if her parents or other blood relatives have some allergic reactions to some drugs, suffer from chronic diseases, or died because of certain health problems.
Such information can be used to prevent negative outcomes of the chosen treatment problems and avoid undesirable effects. Second, additional information about past visits to hospitals is required as it can help to clarify the last official recommendation and the condition of her health at that moment. Finally, specific attention should be paid to emotional and behavioral changes, if any. Sometimes, patients do not admit that they gain some new skills or demands. They continue taking their activities without thinking about consequences. Such information can be obtained from family members or friends who contact the patient regularly.
What Are the Recommendations for Managing This Patient’s Medications?
At this moment, the list of medications taken by the patient is rather impressive. It has to be properly managed and analyzed so that the combination of some drugs does not do harm to the woman. Creatine can be safe and helpful for many people who are involved in physical experiences. However, when a person suffers from high blood pressure, Creatine and Lisinopril supplementation can be rather dangerous due to its effects on kidneys (Hall et al., 2014).
At the same time, the patient cannot stop taking the drug that helps to control her blood pressure. Therefore, it is recommended to re-think the necessity of using Creatine for muscle building and focus on the work of her kidneys and the pain these problems may cause.
Several general organizational recommendations can be given to the patient who takes several drugs at the same time. First, a chart or a calendar has to be created so that the patient is sure what medication is taken and when. Second, a pill organizer is required in order not to confuse medications and not to have many bottles and packages. Finally, it is necessary to take all medications as a part of a routine process. In this way, the body can easily get used to the schedule, and no unpredictable changes can be observed.
What Are the Components for Educating the Patient?
The main concern of this case is that the patient made several medical decisions without consulting a clinician. She is a diabetic patient. Her treatment cannot be ignored. Therefore, education turns out to be a significant part of her life. It is not an easy task to live with diabetes. The main areas of education, in this case, are self-management and the importance of controlling the blood sugar level and drug-taking, lifestyle and changes that can be appropriate, and communication with medical workers on a regular basis (Pradeep & Haranath, 2014). The patient has to understand that her intentions to improve the quality of life are usually appreciated.
But, she has to discuss them with a person who is aware of possible pharmacological and physiological peculiarities of her condition. A doctor educates the patient about the interactions of the chosen drugs and explains that though separately they can help to stabilize the condition, altogether they may lead to a number of adverse effects.
What Are the Important Components Necessary on the Packaging or on the Label While Prescribing a Medication?
In this case, the patient has three diseases that may have an impact on the work of her body and cause back pain. At the same time, back pain may be a symptom of serious kidney problems. The prescription of drugs is not enough. A clinician has to evaluate the risk level of weight loss and blood clots, also known as post-thrombotic syndrome. Kidney problems have to be taken into consideration. Regarding these health conditions and possible effects, information on the packaging or the label cannot be ignored. Such components as the presence of sugar and creatine in drugs have to be evaluated. NSAIDs are usually contradicted for such patients as the one under analysis.
Carisoprodol can be prescribed to relieve pain without any considerable side effects regarding the fact that the patient has diabetes and hypertension. Rx.: Carisoprodol 350 mg; Sig.: Take 3 times a day; Disp.: #30; Refill: no (Paul, Parshotam, & Garg, 2016). It can be used as a pain reliever and a muscle relaxant to substitute Creatine and Coenzyme Q10 when back pain is hard to control. At the same time, it is not as harmful to diabetic patients as many other pain relievers available today.
Hall, M., do Carmo, J. M., da Silva, A. A., Juncos, L. A., Wang, Z., & Hall, J. E. (2014). Obesity, hypertension, and chronic kidney disease. International Journal of Nephrology and Renovascular Disease, 7, 75-88.
Paul, G., Parshotam, G. L., & Garg, R. (2016). Carisoprodol withdrawal syndrome resembling neuroleptic malignant syndrome: Diagnostic dilemma. Journal of Anaesthesiology Clinical Pharmacology, 32(2), 387-388.
Pradeep, T., & Haranath, C. (2014). A review on diabetes mellitus type II. International Journal of Pharma Research & Review, 3(9), 23-29.
Zhang, Y. P., Mei, S., Yuan, Y., Eber, A., Rodriguez, Y. & Candiotti, K. A. (2016). Acute hypoglycemia includes painful neuropathy and the treatment of coenzyme Q10. Journal of Diabetes Research, 2016. Web.