Polypharmacy Strategies

Improved Essays
STRATEGIES TO COMBAT THE ADVERSE EFFECTS OF POLYPHARMACY AND THE ASSOCIATED NUTRITIONAL RISK
Research suggested while polypharmacy, isn’t the only cause of nutritional risk in the elderly, it was shown to have a positive correlation with increased prevalence of nutritional risk. It therefore stood to reason if one reduces negative polypharmacy use, where medications dispensed have little to no added therapeutic value but rather precipitate additional symptoms, we can decrease the numbers of geriatric patients at nutritional risk.
Alpert and Gatlin, (2015) detailed several strategies that have been implemented throughout the years. They believed healthcare professionals, home clinicians, the patients and their families all have a collective
…show more content…
According to Jett (2012) older adults purchase 40% of their medication over the counter (OTC) and are three times likely to be taking one or more. It was also important that the professional reviews the patients’ use of these medications. The author believed the medication review could help reduce duplicate medications, medications that are contraindicated for older adults and provide ways to ensure patients understand why they are taking the medications as well as how to take them correctly. During the review, he also emphasized the need to inquire if patients are using multiple pharmacies to fill their prescriptions. The author suggested older patients use one pharmacy to help reduce the risk of polypharmacy occurring.
Home healthcare clinicians should also assess adherence to medications during routine review, to ensure medication regimen isn’t too complex, especially in patients with dementia or who are depressed. He proposed the general rule of minimizing the number of prescribed medications with simple dosing schedules, with the assurance that the right drugs are given in the right circumstance to treat the right
…show more content…
Propranolol serum levels may be increased if taken with protein rich foods. Diets rich in carbohydrates and low in protein have also be shown to have been beneficial as low carbohydrate/high protein diets tend to increase propranolol’s oral clearance. Smoking also increases its metabolism by decreasing it’s plasma levels. Celiprolol’s, a beta-blocker, intestinal absorption is inhibited when it is taken with orange juice. This is due to a component of the orange juice known as Hesperidin. The absorption of ACE’s inhibitors is increased when taken on an empty stomach.
Warfarin
Warfarin is one of the prototypic drugs for treating thromboembolic events. Patients taking warfarin are at particular risk of interactions with dietary supplements, yet approximately 30% use herbal or natural product supplements on a regular basis. A high protein diet interacts with warfarin. It has been postulated that there is a potential for increased dietary protein intake to raise serum albumin levels and/or cytochrome P450 activity. This is one of the mechanisms for the resulting decrease in international normalized ratio (INR).
Some vegetables are an extremely rich source of vitamin K. Broccoli, Brussels sprouts, kale, parsley and spinach are all example of these. Consuming these vegetables in copious quantities or sudden changes in the amounts eaten, may cause increase dangers

Related Documents

  • Improved Essays

    Prilosec Case Study

    • 362 Words
    • 2 Pages

    Prilosec (omeprazole), a proton pump inhibitor that reduces the amount of acid produced in the stomach in conditions caused by excess stomach acid. Prilosec suppresses gastric acid secretion by target inhibition of the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell. This enzyme system is considered as the acid (proton) pump within the gastric mucosa, Prilosec has been characterized as a gastric acid-pump inhibitor, because it blocks the final step of acid production. This result is dose-related and leads to inhibition of both basal and gastric acid secretion regardless of stimuli. Prilosec was prescribed for L.G. to treat his symptoms of gastroesophageal reflux disease (GERD).…

    • 362 Words
    • 2 Pages
    Improved Essays
  • Great Essays

    Altered Pharmacodynamics

    • 837 Words
    • 4 Pages

    Pharmacodynamics: Ibuprofen is a NSAID with anti-inflammatory; analgesic and antipyretics effects are the results of the ability to block the cyclooxygenase (COX) enzyme system, leading to the inhibition of the synthesis of prostaglandins [6]. COX is the enzyme used for prostaglandin biosynthesis [3]. Both COX-1 and COX-2 enzymes are involved with prostaglandin production. The inhibition of these enzymes results in decreased synthesis of prostaglandin thus decreasing pain, fever, and swelling [4].…

    • 837 Words
    • 4 Pages
    Great Essays
  • Decent Essays

    R/s William Wood has degenerative joint diseases, ischemic heart disease, anxiety, chronic back pain, hypertension, diabetes, ongoing arthritis, and lumbar spondylosis. R/s Mr. Wood lives with his wife, Joyce Wood and both are experiencing early stage of dementia. R/s Mr. and Mrs. Wood are sharing medication. R/s Mr. Wood is noncompliant with his medication. R/s a nurse is in the home once a month to prepare Mr. Wood’s medication in pill tray.…

    • 205 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    Heartburn Medical Study

    • 593 Words
    • 3 Pages

    New Study of Veterans Adds to Evidence in Heartburn Medical Lawsuits A study from St. Louis researchers shows indications that heartburn medications can increase the risk of kidney failure and disease. This study, published on April 14 in the Journal of the American Society of Nephrology, revealed the results of more than 170,000 veterans who use these medications. The heartburn medications the study researched included Prevacid, Prilosec, and Dexilant, among others. Details of the Study Researchers used the databases from the Department of Veterans Affairs and compared incidents of both chronic kidney disease and kidney failure for people who used Nexium and other PPI medications with those who used a different type of medication for heartburn,…

    • 593 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    However, education on addiction provided to pharmacists is not satisfactory – they should have enough training to counsel effectively, and help prevent addiction. For instance, Dr. Lynn Lafferty, Pharm. D., a licensed pharmacist who is devoted to discovering the most effective way to endorse wellbeing, states a questionnaire indicates, “A majority of responding pharmacists (67.5%) reported participating in two hours or less of addiction/substance abuse education in pharmacy school” (Lafferty 3). More than half of pharmacists do not have enough knowledge to handle the complexities of addiction, and it is upsetting since addiction can happen to anyone on a psychoactive substance. Also, patient’s health is in pharmacists care when they dispense medication hence, they should be first to identify addictions.…

    • 978 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    My DRI Recommendations

    • 1475 Words
    • 6 Pages

    Therefore, I didn’t meet my average intake. Cobalamin is crucial for the production of ATP from certain fatty acids. A deficiency in Vitamin B12 eventually if not treated can cause paralysis and death (Grosvenor & Smolin, 223). So in order for me to reduce the chances of dying and paralysis; an increase in meats, eggs, and dairy product is vital.…

    • 1475 Words
    • 6 Pages
    Improved Essays
  • Great Essays

    Joint Commission Essay

    • 1469 Words
    • 6 Pages

    The patient must be given information on the medications they should be taking when the patient is discharged from the hospital. The Rosa Parks Wellness Institute for Senior Health (RP-WISH) created a program that focused on improving the safety of care by making an increased effort to schedule follow-up appointments and medication reconciliation within 1 week of discharge. They wanted to make this program because the RP-WISH office manager wanted clinical pharmacy specialists and inpatient pharmacists to be directly involved with medication reconciliation which they were never part of before. The plan was to help in care transitions in regards to medications by reconciling patients’ home medication use with primary care and hospital records (Liu & Garwood, 2015). They intended to call patients that were discharged home when the pharmacy finds medication-related problems and to intervene to resolve those problems to avoid adverse drug effects.…

    • 1469 Words
    • 6 Pages
    Great Essays
  • Improved Essays

    The practitioner provides comprehensive assessment, diagnosis and management of patient problems with both pharmacologic and nonpharmacologic interventions to ensure competence across the entire adult- gerontology scope of practice (Graham, 2011). The nursing arena is not the only one that saw fit to add care of the aging adult to its forum. In addition, the Institute of Medicine (IOM) described a three-tier strategy to address healthcare needs of the aging adult that includes: increasing recruitment and retention of geriatric providers, increasing competency, and improving care (Murphy, et al., 2012). The IOM 's first key message is that "nurses should practice to the full extent of their education and training." (Graham,…

    • 754 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Puritan Pride

    • 493 Words
    • 2 Pages

    Puritans pride as a medicine online pharmacy It is most effective way of getting pharmaceutical medicines from an online store such as Puritans pride. A more useful way you can adopt with your needs and commitment with which you work with the website making provisions for your daily need for pills or other supplements such as Whey protein, is provided.…

    • 493 Words
    • 2 Pages
    Improved Essays
  • Decent Essays

    Otherwise known as HMG-CoA reductase inhibitors Mechanism of Action Inhibit the initial enzyme HMG-CoA reductase of the mevalonate pathway which is one of the main factors needed in the production of cholesterol. Having similar molecular structure to HMG-CoA, they will bind onto the reductase's active site. This will then cause competition with HMG-CoA which will in turn decrease the rate by which HMG-CoA reductase is able to produce mevalonate, the next molecule in the route that eventually produces cholesterol. Examples Atorvastatin (Lipitor), Simvastatin (Zocor), Lovastatin (Mevacor,Altocor), Rosuvastatin (Crestor) Fluvastatin…

    • 110 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    Cultural Considerations

    • 963 Words
    • 4 Pages

    Ethnic, Genetic, and Cultural Considerations in Prescribing Providers are accountable to be culturally competent, empathetic and knowledgeable with treatment options for patients. The following paper addresses pharmacotherapeutics, client compliance and advanced nursing practice. Also highlighted will be resources available to clinicians and how to educate a client on the identification or prevention of potential pharmacodynamics or pharmokinetic problems. Ethnic, Genetic and Cultural Considerations More than 1000 medications have ingredients that may be prohibited in various religions and cultures (Hoesli & Smith, 2011). In addition to religious beliefs, other factors may play a part in medication use such as a vegetarian lifestyle…

    • 963 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Although it is difficult to truly assess adherence, by analyzing pharmacy claims healthcare organizations can focus on and make outreach attempts to members identified as high risk (due to filling a medication used to treat a chronic condition) to help them become or stay current on their medications and tailor treatment plans for them through the use of case management nurses. Providing more one on one physician/patient interaction during routine visits and educational material that is easy to understand are tactics that may help bridge the gap in prescription refill adherence and continue the forward drive to successful preventive…

    • 942 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Medicare Benefits

    • 1287 Words
    • 6 Pages

    In 2002, total outpatient drug costs for adults over 65 were estimated at $87 billion, and they will rise to over $120 billion by 2005.(Brinckerhoff 2005) This presented conflicts in patients affording proper prescription drug treatments and physicians ordering affordable treatments for their patients. In response to rapid increasing drug costs retirement health plans along Medicare advantage plans have scaled back on coverages for prescription drugs. This is the main reason why government introduced drug discount cards as one of the provisions of Medicare Prescription Drug Improvement Act. Although these discount drug cards came with restrictions such as the ability to use one card a time in a calendar year; along with various pharmacy restrictions.…

    • 1287 Words
    • 6 Pages
    Improved Essays
  • Improved Essays

    Wrongful Death

    • 449 Words
    • 2 Pages

    Four Reasons Why the Death of an Elderly Person Can Create a Wrongful Death Lawsuit Often when people think of a wrongful death lawsuit they picture in their mind an auto accident or a defective consumer product, but one area that can result in wrongful death is with the elderly. The most common places that this will happen is in a hospital or retirement home. The following are four reasons why an elderly person can die wrongfully.…

    • 449 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    National Patient Safety Goals: Help Avoid Mistakes with your Medicines Many people assume the role of their medication responsibility to their health care providers, while it is a combined duty of the patient as well (The Joint Commission,2016). In avoiding medication errors in healthcare The Joint Commission has created guidelines to further educate the importance of understanding one’s medications. Patients are given understanding on how to avoid mistakes while in the hospital, at the pharmacist and working with physicians. This paper will discuss The Joint Commissions brochure on “Help avoid mistakes with your medicines” summarizing their guidelines and if the brochure was effective for patients.…

    • 838 Words
    • 4 Pages
    Improved Essays