An elderly patient was on Zyrtec (cetirizine) 10 mg at betime for allergies and was also on Ditropan (oxybutynin) 15 mg three times daily for urinary incontinence. Ditropan is one of those classic older anticholinergic medications that isn’t so great in the...
A patient was having difficulty with symptoms of gout. They were on Allopurinol 300 mg daily for their hyperuricemia (elevated uric acid happens in gout). This particular patient would have flares periodically and had about 3 over the last year requiring the use of...
An 88 year old female was struggling with incontinence. Upon a nursing assessment, this patient was frequently incontinent throughout the day and night. For her Congestive Heart Failure, the patient needed increased doses of diuretics which obviously can make things...
88 y/o with a history of depressive type symptoms was placed on an antidepressant to manage symptoms shortly after admission to a long term care facility. This particular patient was trialed on Zoloft (sertraline) and then transitioned to Cymbalta (duloxetine),...
A patient’s A1C was chronically high at around 9.0 with poor diet compliance. They were already reciving a fairly high dose of a sulfonylurea (glipizide) – remember that sulfonylureas stimulate the release of insulin. They were also on metformin 1000 mg...
This elderly patient had been on a dose of (Neurontin) gabapentin 600 mg three times daily for peripheral neuropathy. Over time, the patient’s kidney function had been declining and was diagnosed with chronic kidney disease. Family had begun to notice that the...