Findings and Concern
In the review of the medication list of the patient in the case study, an apparent major concern is that drug interactions have the potential of causing some adverse effects. In this view, mechanisms of action, drug interactions, and adverse effects are critical for the safe and effective use of drugs. Since the patient has enrolled in an exercise program, her trainer recommended supplementation with Creatinine and Coenzyme Q10 to boost performance during exercise, for they are a muscle builder and an antioxidant, respectively.
Pharmacodynamics analysis indicates that Coenzyme Q10 has adverse effects on the patient because it interacts with Warfarin and antagonizes its function, resulting in decreased efficacy. Theoretically, the interaction of Creatinine and Lisinopril creates adverse effects with the potential of causing kidney problems.
Lisinopril interacts with Glyburide and causes adverse effects through the process of pharmacodynamic synergism. Through the mechanism of drug interaction, Glyburide tends to magnify the effects of Warfarin. Furthermore, the combined consumption of garlic and Warfarin needs close monitoring for their interaction enhances anticoagulation and increases the risk of bleeding disorders.
Additional Information
To understand the health status of the patient, I would get additional information regarding medical history, psychosocial history, eating habits, family history, cultural background, personal beliefs, and education level. According to Gonzales-Zacarias, Mavarez-Martinez, Arias-Morales, Stoicea, and Rogers (2016), demographic, economic, social, and psychological factors play a significant role in the treatment and management of diseases.
I would like to understand medical history because the case study shows that the patient suffers from chronic conditions and has been taking diverse medications. The fact that the patient has had type 2 diabetes for ten years, hypertension, and thrombosis, more information about family history and eating habits to establish predisposing factors and causes is necessary. Moreover, I would like to obtain information about psychological problems because she takes Kava Kava to relieve anxiety.
From the case study, it is apparent that the patient has been suffering from hip and shoulder pains without stating the nature of the work and exercises she has been doing. In this view, I would like to inquire about the economic and physical activities to comprehend health conditions. Since the patient takes over-the-counter medications that her trainer recommends, I would like to know the cultural background, personal beliefs, and education level because they comprise major factors influencing compliance.
Recommendations
After reviewing the case study, I make the following recommendations to the patient to improve her medications.
- Halt the use of Coenzyme Q10 and Creatinine as muscle builders and performance enhancers during physical activity because their interactions reduce the efficacy of Warfarin.
- Adhere to the use of prescribed medications for diabetes (Glyburide), thrombosis (Warfarin), pain (Ibuprofen), and hypertension (Lisinopril) while undergoing regular checkups for effective management of these chronic conditions.
- Discontinue the use of garlic because it magnifies the effects of Warfarin and predisposes her to bleeding disorders.
- Manage a delicate balance between the occurrence of bleeding disorders and thrombosis by regulating the intake of food rich in vitamin K, a major antagonist of Warfarin.
- Since the patient appears to have psychological issues, she should continue using Kava Kava if it is effective in the treatment of anxiety without causing known adverse effects of drug interactions.
Patient Education
The analysis of the case study indicates that the patient requires education to manage and improve her health conditions. Jotterand, Amodio, and Elger (2016) assert that patient education is integral in the treatment and management of diseases because it boosts their autonomy and enhances their involvement in the healthcare process. Competent personnel, supportive family members, customized education, and active patients are major stakeholders in health education. Competent personnel diagnose the health conditions of patients and provide comprehensive education to improve health literacy.
As family members form an immediate social circle, their support is essential in enabling patients to overcome psychosocial issues, comply with medications, and manage chronic conditions. Owing to the diversity of patients’ needs, customized education is critical in promoting health literacy. In patient-centered models, effective health education requires the participation of patients in the decisions of their treatment processes.
Components of Packaging Medications
Packaging and labeling of medication determine their use and safety in the treatment of diseases. Wolf et al. (2016) explain that the misuse of drugs that results in adverse health outcomes emanates from poor label instructions and limited literacy of patients. Therefore, accurate labeling of medications not only increases the safety of their use but also effectiveness and adherence among patients.
Since the patient presented to the clinic with shoulder and hip pains, I would prescribe the following medications because Ibuprofen, which is a nonsteroidal anti-inflammatory drug, has potential drug interactions with the prescribed medications.
- Replace Glyburide with Metformin 500 mg to be taken every 12 hours for two weeks while monitoring blood sugar level before meals.
- Prescribe oral Oxycodone 5 mg for the patient to take every 12 hours to relieve pain for seven days.
- Substitute Lisinopril with the daily oral dosage of Hydrochlorothiazide 12.5 mg while checking the blood pressure regularly.
The pharmacy would process the prescription by providing appropriate information for the patient to understand dosage and mode of administration. Specifically, the packaging label should contain detailed information indicating the names of the prescriber, the patient, and the drug, as well as warning info, reference number, and the name of the pharmacy. Moreover, the packing label should contain instructions for use, which stipulate the quantity and frequency of dosage.
References
Gonzales-Zacarias, A. A., Mavarez-Martinez, A., Arias-Morales, C. E., Stoicea, N., & Rogers, B. (2016). Impact of demographic, socioeconomic, and psychological factors on glycemic self-management in adults with type 2 diabetes mellitus. Frontiers in Public Health, 4, 1-8. Web.
Jotterand, F., Amodio, A., & Elger, B. S. (2016). Patient education as empowerment and self-rebiasing. Medicine, Health Care, and Philosophy, 19(4), 553-561. Web.
Wolf, M. S., Davis, T. C., Curtis, L. M., Bailey, S. C., Knox, J. P., Bergeron, A.,…Wood, A. J. J. (2016). A patient-centered prescription drug label to promote appropriate medication use and adherence. Journal of General Internal Medicine, 31(12), 1482-1489. Web.