Question:

Mrs Angela Brown, who is a widow at 68, is returning to hospital for the second month.

She lives alone and doesn’t have any relatives nearby.

Angela has suffered from intermittent asthma, atrial fibrillation and osteoarthritis.

Metronidazole 500mg IV to treat a pelvic enlargement was given to Angela while she was in hospital.

She has a recurring feeling of pain and discomfort in her pelvis.

Paracetamol 1000mgqid is prescribed as pain medication.

Paracetamol is listed as a current medication in addition to Metronidazole.* Salbutamol 2 puffs pit* Amiodarone 200mg daily* Aspirin 300mg daily

Angela also takes Ibuprofen 200mg for any pain in her joints.

Angela’s safety and effectiveness is a part of Angela’s responsibility in the discharge planning.

This process can be started by answering the following questions regarding medication management:1.

What are the indications, actions, and side effects of the prescribed medicines?2.

What are some of the most common interactions among prescribed medications?

Include drug to drug interaction, drug to food interaction and drug to herbal interaction.

Please state if interactions are not known in any area.3.

Discuss the medication management education required for Angela to be able manage her medications at home.

Answer to Question: NURSING 2010 Pharmacology In Nursing II

Drugs: Indications and actions

Drugs

Indications

ActionsMetronizadole

SS Anaerobic Infections

SS Parodontopathy. (Turnbull Lin & Matthews 2013).

SS Anaerobic Infections of the Lower Reproductive Tract

SS was joined with a moment antibiotic for the treatment and prevention of mixed diseases with oxygen consuming bacteria (Turnbull Lin & Matthews (2013)).

This interferes with the nucleic-acid synthesis process by altering the DNA of microbial organisms.

When metronidazole dose is insufficiently reduced, the capacity of the body will be diminished.

The effects of oxygen consuming microorganisms on human cells and other cells are generally minimalParacetamol

SS Pain relieving properties and antipyretic.

SS is used to treat various kinds of pains (migraines/dental agony/postoperative torment), torment concerning colds and posttraumatic muscle torment.

SS Headache cerebral pains and dysmenorrhea (Machado et.al. 2015).

Paracetamol (acetaminophen), has been widely considered to be a weak inhibitor of the combination of prostaglandins.

Paracetamol’s in vivo impact is similar to that of COX-2 inhibitors.Ibuprofen

SS Nonsteroidal medication (NSAID).

SS Decreases hormones which cause irritation and torment in your body.

SS To lower fever and treat pain caused by a variety of conditions, such as toothache, back pain, joint inflammation or minor damage.

Ibuprofen acts as a non-specific inhibitor of a catalyst known as cyclooxygenase, (COX), that is necessary to unite prostaglandins by the arachidonic acid corrosive pathway.

COX is expected change from arachidonic acid to prostaglandin corrosive (PGH2) in body (Shetty, et al. 2013, 2013).Salbutamol

SS Intense treatment to bronchospasms, despite the possibility that they are serious.

SS Fenoterol is comparable to terbutaline. Salmeterol, on the other hand, has a longer-lasting impact.

SS Redress utilization is essential for a productive treatment (Devereaux et.al. 2014).

SS More symptoms require oral organization.

If asthma attacks are severe, you may experience inward breathing with a parenteral organization or a nebulizer.

If the asthma attacks are severe, salbutamol can be used for endless obstructive airway disease.

The unwinding bronchial smooth muscles is caused by binding of albuterol to beta(2)-receptors in the lung. S

Albutamol generates cAMP through the activation of adenylate ciclase. Salbutamol activities are stopped by cAMP. (Mamawag. 2012).Amiodarone

SS Life-threatening recurrent ventricular fibrillation or hemodynamically stable ventricular tachycardia.

SS Amiodarone (also known as SS Amiodarone) is a powerful antiarrhythmic drug that can be used for ventricular arrhythmias or atrial fibrillation.

It also indicates the presence of calcium channel blocker-like or beta blocker-like activities at the SA/AV hubs

By using sodium-and-potassium-channel impacts, it expands the stubborn time and modifies intraheart conduction.

Aspirin

SS Aspirin is comparatively effective as paracetamol for insignificant intense pain (e.g.

You may experience migraines, pain in the teeth, or colds.

SS Rheumatic insufficiencies (incessant polyarthritis. osteoarthritis., etc.).

For dysmenorrhea and headache medicine isn’t as efficient or not also tolerated as other prostaglandin mixture inhibitors, such as ibuprofen (Devereaux et al. 2014.).

SS serves in the aversion for thromboembolic angiopathies.

SS Utilization (after a myocardial or sidestep procedure) is archived for auxiliary prophylaxis of coronary illnesses (Devereaux et al., 2014).

Prostaglandins and TXA2 are reduced.

It irreversibly inactivates the cyclooxygenase COX compound, which is responsible for the creation prostaglandins or thromboxanes (Devereaux et. al., 2014.

Prostaglandin/thromboxane blend requires cyclooxygenase.2.

Drug Interactions With Foods, Other Drugs And Herbals

Drugs

Interactions with food

Interaction with other medications

Herbal InteractionsMetronidazole

It is not known to interact with other chemicals, however it reacts with ethanol and can cause side effects.

It does not react to any drug.

* Ginger improves plasma half-life, absorption

* Increases the rate at which it is eliminated and its clearanceParacetamol

It doesn’t react to citrus foods.

It increases liver damage risk in chronic alcoholics.

This is not a dangerous interaction.Ibuprofen

Food can interfere with the absorption of ibuprofen.

Ibuprofen reduces the side effects of furosemide.

It is a strong anti-inflammatory, analgesic, and antipyretic.

Ibuprofen increases the possibility of lithium toxicity and methotrexate toxicities.

Paracetamol is also able to block its analgesic and antipyretic effects.

Gingko, which has a blood-thinning action, can increase the risk of bleeding when used with drugs that thin the body.Salbutamol

It doesn’t react to most foods.

Certain medications are contraindicated with salbutamol (also known albuterol), and should not be taken without consulting a specialist.

Salbutamol affects the sensory system in a manner that is indistinguishable from monoamine oxide (MAO), inhibitors, or tricyclic counterdepressants. This can lead to serious cardiovascular problems.

One symptom of salbutamol is that some diuretics can lower potassium levels.

Salbutamol is a beta-blocker, which may render it ineffective.

Salbutamol could have a negative effect on digoxin-taking individuals.

Salbutamol should not be used in conjunction with furazolidone or linezolid (Hostrup et. al., 2016,).

* It reacts to caffeine. For over-stimulating your cardiovascular system, you can use Ephedra, Licorice, and Ginseng.Amiodarone

Amiodarone must be taken with care. Avoid grapefruit juice, and grapefruit juice.

Aside from that, there are no side-effects to this drug.

Amiodarone has an effect on the pharmacokinetics a variety of medications, some of which are not ordinarily controlled by people suffering from coronary disease.

It stimulates warfarin activity by reducing the leeway of (S) as well (R).

Amiodarone inhibits the activity from the cytochrome P450 isozyme group.

* Grapefruit juice blocks the digestion of Amiodarone in your intestine.

* Tobacco may also cause health problems (Gehring et. al., 2014.)

Aspirin

They are not allowed to be consumed with alcohol.

Aspirin comes from a category of medication that is commonly used both as remedy and over-the counter. These are called nonsteroidal mitigation drugs (NSAIDs), for example, ibuprofen and naproxen.

Gingko will have you in common3.

Medication Management

Angela will need to be given a written medication guideline by nurses.

The nurses will provide Angela with a proper medication guideline. This helps to improve the quality and reduce the amount of drugs that are being used.

If the following steps are followed, a good medicine management can be achieved.

Step 1: Angela must be evaluated by the nurse. She will also need to perform the following steps

Angela is being examined by a medical practitioner.

Step 2: Examining her medications

Matching the medicine to the goals of treatment

Identify discrepancies between prescriptions and medicines

Step 3: Optimize the Angela-prescribed medications

Evaluation of both signs and symptoms of medicinal issues

Take into account the dose adjustments (Raskinet al. (2014)

Step 4: Continue the management of angela’s medicine by following up on the action taken.

Monitoring the medication or communicating with it

Anticipating adverse outcomes

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Aspirin is given to patients who have undergone non-cardiac surgery.

New England Journal of Medicine (370(16), 1494-1503).Gehring, G., Rohrmann, K., Atenchong, N., Mittler, E., Becker, S., Dahlmann, F., … & Ciesek, S. (2014).

Verapamil, dronedarone and amiodarone have been clinically approved to prevent filovirus cells from entering.

Journal of Antimicrobial Chemotherapy. 69(8). 2123-2131.Hostrup, M., Kalsen, A., Auchenberg, M., Bangsbo, J., & Backer, V. (2016).

Two-week and acute administrations of oral salbutamol to athletes on exercise performance, muscle strength, and training efficiency.

Scandinavian journal of medicine and science in sports 26(1), 8-16Machado, G. C., Maher, C. G., Ferreira, P. H., Pinheiro, M. B., Lin, C. W. C., Day, R. O., … & Ferreira, M. L. (2015).

Systematic review and meta-analysis on randomised placebo-controlled trials to assess the safety and efficacy of paracetamol in spinal pain and osteoarthritis. bmj, 350, h1225.Mamawag, E. M. T. (2012). Metronizadole-induced Encephalopathy in a 64-year-old Female: a Case Report.

Philippine Journal of Microbiology and Infectious Diseases.Raskin, S. A., Maye, J., Rogers, A., Correll, D., Zamroziewicz, M., & Kurtz, M. (2014).

Prospective memory in schizophrenia. Relationship to medication management skills and neurocognition. Neuropsychology, 28(3), 359.Shetty, N., Patil, A. K., Ganeshkar, S. V., & Hegde, S. (2013).

Human study to compare the effects of PGE 2 in the GCF on orthodontic tooth movement.

Progress in orthodontics 14(1), 6.Turnbull, A.M.J., Lin, Z. & Matthews, B.N. (2013).

Giardiasis is the cause of severe bilateral anterior veinitis. It was initially misdiagnosed by doctors as a side effect. Eye, 27(10), p.1225.