Medication in the Elderly

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QUESTION
 
You are assigned a new admission. The client’s diagnoses include:
1) Dementia
2) Parkinson’s disease
3) CVA with residual L-sided weakness
4) Osteoporosis
5) Urinary incontinence
6) Recurrent UTIs
7) Hypertension
8) CAD; stent 2 years ago
9) CHF (EF 30%)
10) Atrial fibrillation
11) Hyperlipidemia
12) Osteoarthritis, especially hips and knees
13) Macular degeneration
14) Type 2 DM
15) Peripheral neuropathy
16) Chronic renal insufficiency
17) Anemia
18) Hypothyroidism
19) COPD on oxygen
20) Diverticulosis
The client’s medication list includes:
1) donepezil (Aricept) 5 mg PO daily
2) Sinemet 10/100 PO TID
3) aspirin 325 mg PO daily
4) warfarin (Coumadin) 5 mg PO qHS
5) tolterodine (Detrol) 2 mg PO BID
6) atorvastatin (Lipitor) 40 mg PO qHS
7) insulin (long-acting and sliding scale)
8) gabapentin (Neurontin) 300 mg PO TID
9) iron sulfate 325 mg PO TID
10) trazodone 50 mg PO qHS
11) levothyroxine 50 mcg PO daily
12) furosemide (Lasix) 60 mg PO BID
13) potassium chloride 20 mEq PO daily
14) metoprolol 100 mg PO BID
15) lisinopril 20 mg PO daily
16) amlodipine 10 mg PO daily
17) acetaminophen 1,000 mg PO TID
18) docusate sodium 100 mg PO BID
19) polyethylene glycol powder (Miralax) 17 g PO daily
20) tiotropium (Spiriva) 18 mcg inhaled daily
21) montelukast (Singulair) 10 mg PO daily
22) fluticasone/salmeterol (Advair) 100/50 inhaled BID
23) Albuterol/Atrovent nebulizers PRN for wheezing
24) multivitamin one PO daily
25) vitamin E 400 IU PO daily
26) calcium carbonate 500 mg PO TID
27) vitamin D 800 units PO daily
28) kava root 100 mg PO QID
29) nitrofurantoin (Macrobid) 100 mg PO qHS
Based on your review of the three references found in the library guide under readings and the information in the case study:
1) List three medications you would have concerns in administering to an elderly client and explain why.
2) Discuss what alternatives you might recommend to either the client or provider.
3) Describe the teaching and/or information you would need to provide to ensure the client understands the medication regimen prior to discharge.

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