Question

C.J. is a 71-year-old woman who presents for follow-up. She complains of hard, dry stools over the past week. She remembers reading an educational brochure she picked up in her pharmacy that suggested increasing her fiber and fluid intake, but this has not alleviated her problem. C.J.’s past medical conditions include hypertension and chronic renal insufficiency. She had a stroke 1 year ago with little or no residual. Her medications include verapamil SR 240 mg daily, lisinopril 10 mg orally once daily, calcium carbonate 1,250 mg twice daily orally, and aspirin 325 mg orally once daily.

1. List the specific goals for treatment for this patient.
2. What drug therapy would you prescribe? Why?
3. What are the parameters for monitoring the success of therapy?
4. Discuss specific patient education based on the prescribed therapy.
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
6. What would be the choice for second-line therapy?
7. What OTC or alternative medications would be appropriate for this patient?
8. What dietary and lifestyle changes should be recommended for this patient?
9. Describe one or two drug-drug or drug-food interactions for this patient.
10. Write your prescription for this patient.

Answer 1

The specific goal for the treatment are relief of constipation, and normalization of gastrointestal motility,

laxatives, lactulose syrup, senna,bisacondyl,stool softners It may relieve constipation.

Eat meals regular intervals,gradually increase the amount of high fibber food in your diet,select more fruits and vegetables.

Adverse effects are, Bleeding from rectum, Loose stools, Dehydration,Lethargy.

Second line laxatives are Polyethyline glycol lactulose are second line treatment.

Add more fiber to diet,take a fibre suppliment,increase water intake,get screening