MANILA CENTRAL UNIVERSITY COLLEGE OF MEDICINE

DEPARTMENT OF PHARMACOLOGY
SGD ON GERIATRICS

LEARNING OBJECTIVES:
1. Correlate the manifestation presented by the patients with the effects of the drugs taken
by the patient
2. Understand the risk and vulnerability of elderly to adverse drug reaction and drug
interaction
3. Create a plan on how to avoid or reduce complications of ADR and DI among elderly

STUDENTS MUST HAVE A PRIOR KNOWLEDGE ON THE FOLLOWING:

1. Physiological changes among elderly in handling drugs.
2. Mechanism of adverse drug reactions and drug interactions.

CASE: “The Peril of Too Many”

Edelina 74-year-old woman medium builtconsulted to a health care facility because of red spots
and patches like bleeding beneath her skin all over her extremities for the last several days. She
also has noticed that her stool seems to be a lot darker. She describes it looking almost like
coffee ground. She just relocated to the area to live with her daughter after her home was
destroyed by fire 5 months ago. This is her initial visit to the doctor, as she had refills available
for all of her medications and previouslyfelt fine.

Edelina’spast medical history is notable for being hypertensive,postmenopausal, having an

irregular heartbeat, and according to her previous doctor her heart is failing and she has also a
touch of diabetes controlled with diet.Her prescribed medications for her heart condition
areHydrochlorothiazide, digoxin, Losartan and warfarin. Her over-the-counter medications
include aspirin which she started taking since moving to the area, a multivitamin, paracetamol
for her arthritis and ibuprofen for when her knees really bother her. She also admits to regularly
drinking herbal teas.

TASK:
1. How will you explain the problems of Edelina using a concept map?
2. What mechanisms are involved in the development of such condition?
3. What advices will you give to avoid recurrence of such condition?

Definition of Terms:

Postmenopausal- This is the name given to the period of time after a woman has not bled for
an entire year (the rest of your life after going through menopause). [ CITATION Men18 \l 13321 ]

Salient features: sasabihin lang ito isa isa, sunod sunod hahaha

*patient is 74 year old (carpena)

*red spots and patches or petechiae (caudal)
*dark colored stools (cachola)
*hypertensive (bariuad)
*controlled DM (barroga)
*irregular heartbeat (camacho)
*postmenopausal stage (bueno)
*medications (bartolo)

Since the cause of bleeding is due to drug interaction of the intake of aspirin since moving to the
area and ibuprofen for her arthritis, we must first advice the patient to shift from these drugs to
an alternative one and provide non-pharmacological intervention to her condition.

Pharmacological alternative

 Shift from Aspirin

Tyenol A (Acetaminophen)- This is a widely used drug alternative for aspirin. This is
given to patients that are used to take aspirin but experience adverse effect such as allergy and
bleeding tendencies. This is an analgesic drug that temporary reduce the effect of pain from
arthritis, common colds and influenza, headache, sore throat, toothache, backache, menstrual
cramps, and muscle pain.
NSAIDs- Cream- application of cream provide a lesser side effect and can treat pain for
musle or joint pain.
 Shift from Ibuprofen
 Glucosamine supplements- It helps in treating mild to moderate arthritis. Oral
drug treatment for osteoarthritis and joint diseases. This drug is usually combined
with chondroitin. Glucose levels should also be monitored in diabetic patients.
 Arnica- it is a homeopathic medication that helps in treating soreness, bruises,
and arthritis. Usually taken orally or topically 2 times daily for a week
 Turmeric- this is from curcumin spice that has an inflammatory properties that
helps in arthritis. This is taken 500mg x 2 times daily.