Can you please respond to this article

Can you please respond to this article below The Case I have chosen involves a 69-year-old white female with morbid obesity. She weighs approximately 350 lbs and has diabetes, COPD, and CHF. She also has a history of UTIs, chronic pain in her knees, edema in bilateral lower extremities, and depression and anxiety. She is bedridden and is on supplemental oxygen at 2 liters during the day and 4 liters with BiPAP at night. Considerations for drug therapy are complex for this individual including, age, gender, and comorbidities that affect metabolism, body weight, and drug tolerance. A combination of comorbidities and multiple drugs increases drug sensitivity in older adults (Rosenthal, L., & Burcham, J. (2021). Close observation of potentially harmful drugs according to Beer’s list should be made (Journal of the American Geriatrics Society, 67(4), 674-694. 2019). Age can also affect absorption and excretion rates as well as body weight. Gender can affect the metabolism of drugs, especially narcotics. This resident takes Tylenol 1000mg three times a day for pain as well as Gabapentin 300mg bid with only prn use of narcotics. Careful observation of prn narcotic use and lab work to monitor renal function with these two medications should be considered. The geriatric population should reduce Tylenol intake to 3000mg relative to the standard to not exceed 4000 daily. Comorbidities can complicate the management of other conditions and are at risk of increased drug interactions. Medications used for residents’ CHF can have effects on residents’ COPD. Medications for CHF can also alter electrolyte status therefore regular measurements of electrolytes through a basic metabolic panel are suggested. Drug tolerance is a “decreased responsiveness to a drug as a result of repeated drug administration” (Rosenthal, L., & Burcham, J. (2021). In this individual tolerance could be an issue if the resident were to have scheduled narcotics. It can also occur in diuretic therapy. Sometimes it is necessary to switch to an alternate medication that acts on another receptor site to gain the desired effects. Collaboration between nurse practitioners and Pharmacists for complicated patients may serve to reduce medication errors and improve patient outcomes (Sabatino, J.A., Pruchnicki, M. C., Sevin, A.M., Barker, E., Green, C. G., & Porter, K. (2017). References American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. (2019). Journal of the American Geriatrics Society, 67(4), 674-694. Rosenthal, L., & Burchum, J. (2021). Lehne’s Pharmacotherapeutics for advanced practice providers (2nd ed.). Saunders. Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students Links to an external site. Links to an external site.. Journal of the American Association of Nurse Practitioners, 29(5), 248-254. doi:10.1002/2327-69 SCIENCE HEALTH SCIENCE NURSING NURS 6002

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