Medication history

Name: Maria Hall

Why: To understand relationship between disease process and pharmacological therapies
Where: Clients home
Who: TJ, 77 year old Male who is Capable of participating in interview.
Introduction- I introduced myself and thanked him for allowing me his time. I spoke of the intent of the
meeting and the types of question I would be asking. We sat at the dining table in his home to conduct the
interview.
Review past medical history
Client is a Caucasian of European descent, holds a masters degree, is married and is retired. He
has no known allergies. He is alert and oriented x 4.
Family history includes: High incidence of cancer in family (throat, brain, prostate), COPD, and
osteoporosis
Childhood illnesses include: Pneumonia age 5, Tonsils and adenoids age 6, Chickenpox and
measles age unknown
Immunizations include: Influenza taken annually, Pneumonia, Shingles, DTP, and Polio
Previous Surgeries include: Removal of 2 melanomas and 1 basal cell carcinoma, R shoulder
repair- 1990, appendix removed 1992, Transurethral resection 2006, Prostate removed- 2007
Disease states: Prostate cancer, GERD, Arthritis, 1 incidence of mini- stroke, chronic back pain,
hypercholesterolemia
Drug List (See page 3)
Concerns or barriers
Have you had problems that can be attributed to the medications? The Eligard causes hot flashes
that require sitting in front of fan and wiping sweat off brow to alleviate the symptoms.
Are you able to safely take medications as prescribed? Yes, they are taken as directed on
package. Client is able to afford all medications and does not need to skip doses due to financial
restraints.
What information or instructions were you given when the medications were first prescribed?
Prescribing doctor explained the purpose of the drugs as well as the side effects. The insert

included by the pharmacy when medications are filled is read as well. Client also owns a drug
handbook to reference.
Do you think the medications are doing what they were prescribed to do? Yes, the eligard is
keeping the PSA levels down. The Omeprazole prevents the acid reflux from reoccurring.
Does anyone else help you take your medications? Client and his wife remind each other to take
medications. Medications are taken at certain times of the day with the exception of eligard and
tramadol. Eligard is administered at physicians office. Tramadol is usually taken in the evening
after the days activities.
Reflection
A question that would have been good to ask might be that there are other types of drugs out
there to treat the disease state that he has. I do wonder if there are other medications that he has tried in
the past and have not worked for him to get him to this point of this combination of drugs.
He has a good way of taking his medications. He rarely misses a dose, maybe once in a month.
He has his medications on his dresser in their marked bottles. He follows a daily routine to work in the
administration of his medications. He also gets a 90 day prescription mailed to him through his insurance
provider. This helps to minimize running out of medication.
In the future, I would like to know how the PSA levels have been since his prostatectomy. I am
curious to know if the levels have steadily decreased over time or that they remained low and the eligard
is what is keeping them at that level. I would like to know more about the treatment of his family who
passed from prostate cancer to see if there are any similarities.
In completing this assignment, I learned how important it is to ask the right questions to gather
the information that is most helpful. It is also a challenge to bring the person back on topic when they are
being open by sharing stories and life events. It is a soft skill to learn how to guide the questioning in the
correct direction. Knowing the drugs side effects prior to meeting may have helped in questioning to
possible problems with the medications. Overall the client is in great health for his age. His eats fruits
and vegetables at each meal. He uses lean cuts of meat and bakes, grills, or broils them instead of
frying. He eats all whole grains. He also exercises every other day for an hour and stretches every
morning. He has close relationships with friends and family and enjoys a hobby which includes physical
activity.

His disease does not limit his daily life in a major way, in part due to his positive and proactive

approach to life.
Name

Aspirin

Dose

Frequency

Reason
for use

How
long
taken

Pharmacokinetics

325mg

Once daily

Stroke
prevention

Since
2011

Absorption: from upper small intestine

Distribution: rapidly and widely distributed; crosses
placenta and breast milk

Increase risk of bleeding

thrombolytic agents, dipy
eptibatide. Cefoperazone

Metabolism: liver
Excretion: kidneys
Half-life: 2-3 hr

penicillins, phenytoin, me
agents, and sulfonamide
ACE inhibitors.
Ibuprofen decreases asp

Simvastatin

40mg

Once daily

Cholesterol
lowering
agent

Since
2011

Absorption: 85% absorbed, but rapidly

metabolized
Distribution: unknown
Metabolism: liver, mostly during 1st pass
Excretion: bile and feces, 13% excreted
unchanged by kidneys
Half-life: unknown

Risk of myopathy and rh

cyclosporine, gemfibrozil
telithromycin, protese inh
ketoconazole, itraconazo
contraindicated. Risk of m
amiodarone, amlodipine,
lomitapide, or niacin. Inc
increase serum digoxin l

Omeprazole

20mg

Once daily

GERD

Since
2011

Absorption: rapidly absorbed following oral

administration
Distribution: Good distribution into gastric parietal
cells
Metabolism: Liver
Excretion: urine and feces
Half-life: 0.5-1 hr (3hr in liver disease)

Decreased metabolism a
diazepam, digoxin, flurae
saquinavir, tacrolimus, an
ketoconazole, itraconazo
decrease effects of ataza
warfarin. Decreased anti
cilostazol. Rifampin may
Increased risk of digoxin
methotrexate.

Eligard

45mg

Every
6 months
SUBQ
injection

Advanced
prostate
cancer
prevention

Since
2007

Gonadotropin releasing hormone (GnRH)

agonist.
Distribution, metabolism, and excretion are
unknown.
Half-life: 3hr

Increases antineoplastic

Tramadol

50mg

As needed

Chronic
back pain

Since
2013

Absorption: 75% after oral administration

Distribution: crosses placenta; enters breast milk
Metabolism: liver
Excretion: 30% unchanged in urine
Half-life: 6-8hr

Increased CNS depressi

sedative. Hypnotics, opio
Risk of seizures high dos
phenothiazines,opioid an
require higher dosages f
Quinidine, fluoxetine, par
erythromycin may increa
with SSRI and SNRI anti
CYP2D6 inhibitors, and C