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University of St. Augustine for Health Sciences *
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5135
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Medicine
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Apr 3, 2024
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Uploaded by CommodoreSeahorsePerson747
Case 5: You are working with a 27-year-old client that has chronic back pain, diabetes, and is obese. He is being seen in an outpatient clinic for back pain and decreased participation in IADLS secondary to pain. He has had chronic back pain for five years. His doctor has prescribed physical and occupational therapy to try nonpharmacological pain reduction techniques and education on activity modifications in an attempt to reduce the client’s pain. The client’s current prescriptions include Metformin, Meperidine,
and Avapro. What is each of these medications for? What are the potential side effects of the medications? Are there
any known drug interactions? How might these medications benefit the client's functioning? How could these medications interfere with the client's functioning?
Metformin- Used For: This medication helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Potential Side Effects: Diarrhea, bloating, stomach pain, gas, indigestion, constipation, unpleasant metallic taste in mouth, heartburn, headache, flushing of the skin, nail changes, muscle pain. More serious side effects include chest pain and rash. With the more serious side effects it is advised to see a doctor immediately. Drug Interactions: 359 drug interactions have been known to interact with metformin. 20 major drug interactions, 310 moderate drug interactions, 29 minor drug interactions. Benefit Client Functions: Using metformin alone, with a type of antidiabetic medicine called sulfonylurea, or with insulin, will help lower blood sugar when it is too high and help restore the way you use food to make energy. For the medication to work properly, it is beneficial for the person to have
a good diet and exercise. Interfere with Client Function: Metformin is considered one of the safest medications for type 2 diabetes. There are side effects that could occur depending on person to person, but hypoglycemia or lactic acidosis can occur if taken incorrectly or over dosing. The more potential side effects like diarrhea or indigestion could slightly interfere with function due to simply not feeling good. If there is a more serious side effect like chest pain or rash it is recommended to seek medical attention and this would interfere with function based on the seriousness of the side effects. Meperidine Used For: Used to relieve moderate to severe pain. Meperidine is in a class of medications opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain. Potential Side Effects: lightheadedness, dizziness, weakness, headache, extreme calm, mood changes, nausea, vomiting, stomach pain or cramps, constipation, dry mouth, flushing, sweating, changes in vision. Side effects that can be serious; agitation, hallucinations (seeing things or hearing voices), inability to get or keep an erection, irregular menstruation, slow or difficulty breathing, seizures, fainting, rash, hives, difficulty urinating.
Drug Interactions: 449 drugs are known to interact with meperidine. 17 disease interactions. 1 alcohol/food interaction. Of the total interactions 170 are major, 276 are moderate, and 3 are minor. Benefit Client Functions: This medication may increase serotonin which may increase mood, wound healing, blood clotting, bone health, sleep. With these improvements the patient would be overall in a better state physically and mentally. Interfere with Client Function: Since the medication is considered an opioid it can be dangerous is not used properly. It can be habit forming is used for a longer period. If the patient is struggling with addiction this would not be a likely option due to dependance. This medication should not be used for chronic pain. Since the patient presents with chronic back pain it would be important to ensure proper use of this medication. Avapro
Used For: Avapro is the brand name for Irbesartan, it is used alone or in combo with other meds to treat high blood pressure. It is also used to treat kidney disease caused by diabetes in patients with type 2 diabetes.
Potential Side Effects: diarrhea, heartburn, excessive tiredness. More serious side effects include swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, hoarseness, difficulty breathing or swallowing. Drug Interactions: there have been 289 drug interactions known to interact with Avapro. 30 majors, 253 are moderate, 6 are minor. Benefit Client Functions: Since the client is currently obese it would be beneficial for them to be on Avapro. It will keep his blood pressure low which is a usual issue when being obese. Since blood pressure would be low it would lower the risk of stroke or heart attack. Interfere with Client Function: This medication can interfere if used with drugs that interact with it. Also the side effects could be an issue even if it is the common side effects. References:
U.S. National Library of Medicine. (n.d.). Metformin: Medlineplus Drug Information
. MedlinePlus. https://medlineplus.gov/druginfo/meds/a696005.html#how MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated Jun 24; cited 2020 Jul 1]. Available from: https://medlineplus.gov/
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Meperidine Interactions checker
. Drugs.com. (n.d.). https://www.drugs.com/drug-interactions/meperidine.html
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