The fourth week of my gerontology internship is the reflection of the first three weeks of the internship. After the mid evaluation, I decided to enhance my nursing skill and focus more on the patient’s medication. I conducted RAI tests on my given patients to see how it is done in a real-life situation. At the fourth week, applying my rehabilitative nursing skills and competence when working as a patient’s responsible nurse and working in accordance with ethical guidelines. I decided to review three different resident medication lists, medication benefits and side effects, interactions. Below is the medication list gathered from residents and the attributes.
RESIDENT ABDE
1. Atorvastatin
Use: Lowers cholesterol and reduces the risk of heart disease.
Side Effects: Muscle pain, liver enzyme elevation, digestive issues, headache.
Interactions: May interact with grapefruit juice, some antibiotics, and antifungal medications.
2. Bisoprolol
Use: A beta-blocker used to treat high blood pressure and heart failure.
Side Effects: Fatigue, dizziness, slow heart rate, cold extremities, depression.
Interactions: Can interact with other blood pressure medications, insulin, and NSAIDs.
3. Divisun (likely Vitamin D supplement)
Use: Treats or prevents vitamin D deficiency.
Side Effects: High calcium levels (hypercalcemia), nausea, kidney issues in excessive doses.
Interactions: Can interact with certain diuretics and calcium supplements.
4. Donepezil
Use: Used for Alzheimer’s disease to improve memory and cognition.
Side Effects: Nausea, diarrhea, insomnia, muscle cramps, dizziness.
Interactions: May interact with anticholinergic drugs, beta-blockers, and NSAIDs.
5. Melatonin
Use: A natural sleep aid for insomnia and circadian rhythm disorders.
Side Effects: Drowsiness, dizziness, headaches, nausea.
Interactions: May interact with sedatives, blood thinners, and blood pressure medications.
6. Mirtazapine
Use: An antidepressant used for depression and sometimes sleep disorders.
Side Effects: Drowsiness, weight gain, dry mouth, dizziness.
Interactions: Can interact with MAO inhibitors, alcohol, and sedatives.
7. Pegorion (likely a laxative containing macrogol/polyethylene glycol)
Use: Treats constipation by increasing water content in the stool.
Side Effects: Bloating, diarrhea, nausea.
Interactions: Minimal, but excessive use may affect electrolyte balance.
8. Pradaxa (Dabigatran)
Use: A blood thinner used to prevent stroke and blood clots.
Side Effects: Bleeding risk, stomach pain, heartburn.
Interactions: Can interact with NSAIDs, other blood thinners, and some antibiotics.
9. Finasteride (Finasterid Orion)
Use: Used for enlarged prostate (BPH) and male pattern baldness.
Side Effects: Decreased libido, erectile dysfunction, breast tenderness.
Interactions: Can interact with certain antifungal medications and other hormone-affecting drugs.
Interactions Between These Medications
Blood Thinners (Pradaxa) + NSAIDs or Donepezil: Increased bleeding risk.
Bisoprolol + Donepezil: May cause a dangerously slow heart rate.
Atorvastatin + Mirtazapine: Possible increased risk of muscle issues.
Melatonin + Mirtazapine: Increased drowsiness and sedation.
Are Side Effects Visible in the Client?
It depends on the individual, but common visible side effects could be:
Drowsiness or fatigue (Mirtazapine, Melatonin, Bisoprolol)
Weight gain or swelling (Mirtazapine, Bisoprolol, Finasteride)
Slow heart rate or dizziness (Bisoprolol, Donepezil)
Bleeding or bruising (Pradaxa)
RESIDENTS XYZ
Uses of the Medications:
Foliver – Likely a folic acid supplement used for preventing folate deficiency, anemia, and supporting pregnancy or neurological health.
Memantin (Memantine) – Used to treat moderate to severe Alzheimer’s disease by regulating glutamate activity in the brain.
Linatil (Lisinopril) – An ACE inhibitor used for high blood pressure (hypertension) and heart failure.
Recikalc-D – Likely a calcium and vitamin D supplement used for bone health and osteoporosis prevention.
Thyroxin (Levothyroxine) – A thyroid hormone replacement used for hypothyroidism.
Ceralan – Could refer to a topical medication (e.g., ceramide-based creams) or a lesser-known brand; clarification needed.
Melatonin – A sleep aid used for insomnia and circadian rhythm disorders.
Mirtazapin (Mirtazapine) – An antidepressant used for major depressive disorder, also aids with sleep and appetite.
Pegorion (Macrogol/PEG 3350) – A laxative used for constipation relief.
Minisun – Likely a vitamin D supplement for bone and immune health.
Azopt (Brinzolamide) – An eye drop used to lower intraocular pressure in glaucoma or ocular hypertension.
Possible Side Effects:
Foliver (Folic Acid): Nausea, bloating, allergic reactions (rare).
Memantine: Dizziness, headache, confusion, constipation.
Linatil (Lisinopril): Cough, dizziness, low blood pressure, kidney dysfunction, high potassium.
Recikalc-D: Hypercalcemia (weakness, kidney stones, nausea).
Thyroxin: Palpitations, weight loss, insomnia, sweating.
Ceralan: If topical, potential skin irritation.
Melatonin: Drowsiness, dizziness, daytime fatigue, headaches.
Mirtazapine: Drowsiness, weight gain, dry mouth, increased appetite.
Pegorion: Bloating, diarrhea, abdominal discomfort.
Minisun (Vitamin D): High doses may cause nausea, kidney issues, hypercalcemia.
Azopt (Brinzolamide): Eye irritation, dry mouth, taste disturbances.
Potential Interactions:
Memantine + Mirtazapine – May increase dizziness, confusion.
Linatil + Thyroxin – Lisinopril may reduce levothyroxine absorption.
Linatil + Recikalc-D + Minisun – Risk of high calcium levels, kidney strain.
Mirtazapine + Melatonin – Both cause sedation, increasing drowsiness.
Thyroxin + Calcium/Vitamin D (Recikalc-D, Minisun) – Calcium may reduce thyroxin absorption; should be taken separately.
Azopt + Other Medications – No significant systemic interactions, but caution in kidney conditions.
Are These Side Effects Visible in the Client?
That depends on observed symptoms. Possible signs to check:
Drowsiness, dizziness, confusion → Memantine, Mirtazapine, Melatonin.
Skin irritation → Ceralan.
Weight changes (loss or gain) → Thyroxin, Mirtazapine.
Swelling, muscle weakness, kidney pain → Vitamin D/Calcium excess.
Cough or low blood pressure symptoms → Lisinopril.
Eye irritation → Azopt.
RESIDENT DTY
1. Allonol (likely Allopurinol)
Use: Treats gout and kidney stones by reducing uric acid levels.
Possible side effects:
Skin rash (can be severe)
Nausea, diarrhea
Liver enzyme abnormalities
Hypersensitivity reactions
Interactions: Increases the effects of some blood thinners (e.g., warfarin) and interacts with certain chemotherapy drugs.
2. Bisoprolol
Use: Beta-blocker used for high blood pressure, heart failure, and angina.
Possible side effects:
Fatigue, dizziness
Slow heart rate
Low blood pressure
Cold extremities
Depression
Interactions: May interact with other blood pressure medications, diabetes drugs, and digoxin.
3. Foolihappo (likely Folic Acid)
Use: Prevents and treats folate deficiency, used in pregnancy and anemia.
Possible side effects:
Rare, but may cause nausea or bloating
Interactions: Can reduce the effectiveness of certain epilepsy medications (e.g., phenytoin).
4. Ketipinor (Quetiapine)
Use: Treats schizophrenia, bipolar disorder, and depression.
Possible side effects:
Drowsiness, dizziness
Weight gain
Dry mouth
Low blood pressure
Rare: severe movement disorders (extrapyramidal symptoms)
Interactions: Can interact with sedatives, certain antidepressants, and blood pressure medications.
5. Lixiana (Edoxaban)
Use: Anticoagulant (blood thinner) used to prevent strokes and blood clots.
Possible side effects:
Bleeding (nosebleeds, bruising)
Anemia
Liver enzyme changes
Interactions: Interacts with NSAIDs, other anticoagulants, and some antibiotics.
6. Divisun (Vitamin D)
Use: Treats vitamin D deficiency, supports bone health.
Possible side effects:
Rare, but high doses can cause nausea, kidney problems, or high calcium levels.
Interactions: Can interact with diuretics and calcium supplements.
7. Isangina (Possibly Isosorbide Mononitrate?)
Use: Treats and prevents angina (chest pain).
Possible side effects:
Headache
Low blood pressure
Dizziness
Interactions: Should not be combined with Viagra-like medications (sildenafil) due to severe blood pressure drops.
8. Mirtazapin (Mirtazapine)
Use: Antidepressant used for depression and anxiety.
Possible side effects:
Drowsiness
Increased appetite, weight gain
Dry mouth
Dizziness
Interactions: Can interact with sedatives, alcohol, and MAO inhibitors.
9. Memantin Orion (Memantine)
Use: Treats Alzheimer’s disease.
Possible side effects:
Dizziness, confusion
Headache
High blood pressure
Interactions: Can interact with certain diuretics and other Alzheimer’s medications.
10. Atorvastatin
Use: Lowers cholesterol and reduces heart disease risk.
Possible side effects:
Muscle pain or weakness
Liver enzyme changes
Digestive issues
Interactions: Interacts with grapefruit juice, some antibiotics, and other cholesterol medications.
11. Proteinilsa (Unclear, possibly Protein supplements or Albumin infusions?)
Use: Supports nutrition, used in conditions with low protein levels.
Possible side effects:
Allergic reactions
Kidney strain
Interactions: May interact with diuretics and certain medications affecting fluid balance.
Interactions Between These Medications
Blood thinners (Lixiana, Allopurinol, Atorvastatin): Increased bleeding risk.
Bisoprolol & Ketipinor/Mirtazapine: Risk of low blood pressure or heart rate issues.
Ketipinor & Mirtazapin: Increased drowsiness and sedation.
Atorvastatin & Lixiana: Risk of liver enzyme changes