Mrs Balto Treatment and Medication History - Narrative Paper Example

Mrs. Balto is an 80-year-old Muslim woman weighing 85 kilograms. She is a housewife suffering from HTN, GERD, and occasional knee pain. However, her primary presenting complaint is Gastroesophageal reflux disease. According to her routine diet, she consumes uncontrolled high sodium and fat diet. Currently, she does not suffer from any known allergies or anaphylaxis. Her known history of adverse drug response which had serious side effects such as visual hallucinations and forgetfulness included Enalapril and NSAIDs, Piroxicam and Ibuprofen, Atenolol and NSAIDs, Atenolol and enalapril and Antihypertensives and NSAIDs. To help manage and control Mrs. Balto medical issues, various prescriptions were made. They included 50 mg mane of Atenolol, 10mg mane of Enalapril, 150mg bd of anitidine and 20mg piroxicam for knee pain (Achim, Riddermann & Pfaffenberger, 2005).

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To improve her general health, Mrs. Balto was prescribed for 200 mg PRN of Ibuprofen, a daily multivitamin and 100mg PRN of Sodium docusate. This prescription was seen as important to reduce pain, enable her sleep better, add some vitamins, reduce heartburn and cold season allergies and improve her energies (Johnson & Fennerty, 2004). Although Mrs. Balto smoked 4 to 5 cigarettes per day for 15 years where she has never tried to quit, she does not take alcohol and does not have any history or current alcohol or drug abuse. Regarding dietary supplements, she only takes multivitamins and does not involve the use of illicit drugs such as marijuana, cocaine, heroin or any other. She was advised to always carry Ibuprofen and Atenolol with her and use cold compression for knee pain as a home remedy.

Mrs. Balto is known to smoke 4-5 cigarettes daily which affects her health negatively. Although she is compliance with medication, there are other factors she needs to observe to achieve better health outcome. For this reason some she had to get some teaching and advice on improved lifestyle. First, Mrs. Balto had to reduce or stop her smoking habit. Smoking is known to negative impact on general health such as increasing the Gastroesophageal reflux disease. Reducing the amount of sodium and diet fat together with regular exercise would reduce knee pain and improve her immune system. Medication compliance is important in making sure that she receives a quick recovery.

The other issues relate to Drug-drug and food-drug interactions. Although she did not have severe drug side effect except History of visual hallucinations and forgetfulness, she still needed to observe any changes in her health while on medication. Additionally, she needed to consult a health care professional about any of the over the counter medications to ensure she does not develop drug resistance or end up abusing others. Mrs. Balto should equally get a blood pressure monitoring kit to monitor her blood pressure at home together with regular follow-up from medical professionals.

Issues in Mrs. Balto Treatment

In most of the cases brought forward to hospitals, the patients do not comply to their medication which complicates medication. However, Mrs. Balto is old cannot be able to fully conform to medical instructions. For this reason, she has to receive assistance to close people around her. First is that she is old and cannot take full care of herself. For instance, she needs help in taking a right prescribed medication. Additionally, she has hearing difficulties which inhibit her interaction with others and may need hearing aids. The problem has also been identified in her adherence to drug therapy and compliance. She has been observed to sometimes forgetting her antihypertensive medications and takes over the counter pain medications like Ibuprofen.

Recommended Change in Prescription for Gastroesophageal Reflux Disease (GERD).

GERD has been identified as chronic, degenerating disease that in most cases progress to critical complications. For this reason, Mrs. Balto requires continued therapy that would prevent relapse and complications. As she has erosive esophagitis, she needs long-term acid suppressive treatment which she can afford with the health insurance cover she has. With this prescription, she will receive effective treatment to reduce and control the symptom, improve her quality of health, lowers the occurrence of GERD complications as well as reduces the cost of this disease. Additionally, she will require proton pump inhibitors to maintain the treatment (Halstead, 2005). Such will include oral pantoprazole in the treatment of erosive esophagitis and non-erosive which has a better result than histamine H2-receptor antagonists.

If those prescription is not working in a better way, oral pantoprazole has shown improved quality of life for GERD patients. It is associated with better levels of satisfaction with patient therapy. As GERD is more common and more severe with elderly, pantoprazole is the best prescription as it is effective treatment especially for this at-risk population. Mrs. Balto suffers from gastroesophageal reflux disease (GERD) and would be wise to involve a stepwise approach. It will control symptoms, heal esophagitis, and prevent recurrent esophagitis or any other complications (DeVault, Lynn, Bochenek, Mack, Karlstadt & Metz, 2003). For this reason, the treatment would include lifestyle modification and controlling gastric acid secretion by using anti-acids as medical therapy. In extreme conditions, surgical treatment of corrective anti-reflux surgery may be used

References

Achim, A., Riddermann, T., & Pfaffenberger, B. (2005). Pantoprazole 40 mg is at least comparable to esomeprazole 40 mg in achieving endoscopically confirmed healing and symptom relief of gastroesophageal reflux disease (GERD) after 4, 8 and 12 weeks of treatment. Can J Gastroenterol, 19(Suppl C), DR-0038.

DeVault, K. R., Lynn, R. B., Bochenek, W. J., Mack, M. E., Karlstadt, R. G., & Metz, D. C. (2003). Successful treatment of elderly patients with erosive esophagitis (EE) using pantoprazole 40 mg. The American Journal of Gastroenterology, 98(s9), S3.

Halstead, L. A. (2005). Extraesophageal manifestations of GERD: diagnosis and therapy. Drugs of Today, 41(suppl A), 19-26.

Johnson, D. A., & Fennerty, M. B. (2004). Heartburn severity underestimates erosive esophagitis severity in elderly patients with gastroesophageal reflux disease. Gastroenterology, 126(3), 660-664.