STUDENT SENIOR PARTNERSHIP PROGRAM MARCH 2007 PHARMACOLOGY AND

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Student / Senior Partnership Program

Student / Senior Partnership Program

March 2007

Pharmacology and the Geriatric Patient

Faculty Coordinator: Camille Fitzpatrick, NP [email protected] (714) 456-7832

Learning Objectives.

After completing this session, the student should be able to:

Describe the components of a complete medication history.
Obtain a complete medication history from a senior patient.
Discuss strategies to prescribe appropriately and to avoid polypharmacy.
Discuss age-associated changes in pharmokinetics and pharmacodynamics.
Identify common issues that can lead to medication errors.
Identify ways to improve prescription writing and to reduce medication errors.

Pharmacology Lecture (March 13, 10 a.m. – 12 p.m.)

Lisa Gibbs, M.D. and Brad Williams, PharmD. will present a lecture on Geriatrics and Pharmacology.

Home Visit (BEFORE May 4!)

Schedule a house call with your senior partner. Let your partner know that the topic will be pharmacology (medications), that you will be taking a complete medication history, and that you would like to look through his/her medicine cabinet.
During the house call, obtain a complete medication history. Be sure to include allergies to medications, prescription medications, over-the-counter (OTC) medications, nutritional supplements, alternative treatments, alcohol, caffeine, and recreational drugs. Ask about previous treatments and responses.
Discuss non-pharmacology treatments that your patient uses as alternatives to medications.
Determine what your patient knows about the medications he/she is taking. (Purpose? Mechanism of action? Adverse effects? Interactions with other medications and/or foods?)
Where does your patient get information about medications? (Physicians? Pharmacists? Friends? Media? Internet?)
How does your patient keep his/her medications straight – what medications to take for which symptoms, how often to take them, etc.?
Compare: directions on the prescription label vs. how patient actually takes the medications. Discuss any discrepancies.
Take a look in your senior partner’s medicine cabinet (or wherever he/she stores medications). Make a list of the medications you find. Note the dates that the medications were prescribed, the number of different prescribing physicians, and whether the medication’s purpose is included on the label.
Compare the current medication history you just obtained from your partner with the medications you found in the cabinet. Discuss any discrepancies.
For those of you who have senior partners who are not taking any prescribed medications, focus your inquiries on why that is . . . no need? past experiences? alternative / non-pharmacological modalities (dietary changes to control diabetes, decreased salt to improve blood pressure, moist heat instead of a muscle relaxant, etc.)?
Cost Determine how your patients pay for their medications and the actual out of pocket costs.

After your visit: Explore the answers to any questions or issues that came up during the home visit. If you were your senior partner’s physician, what changes (medications, directions, education, etc.) would you consider?

Small group discussions (May 4 and May 6). Bring your senior partner’s list of medications and be prepared to discuss and turn in your senior partner’s medications, questions, concerns, etc. with a small group of your classmates and faculty from the program in geriatrics.

Reference:

http://www.geriatricsatyourfingertips.com

(Appropriate Prescribing and Pharmacotherapy)

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