Vulnerable population patient case medication choices

 

 

concerning one of the patient cases listed

Determine which medication would be most appropriate to prescribe from the assigned vulnerable population patient case medication choices.
Explain your rationale for choosing this medication. Explain why the other medications listed are not appropriate for this patient.
Explain the dosing schedule for the specific patient including the therapeutic endpoint.
Provide necessary education to the patient to review risks, benefits, and potential side effects of the medication.
Describe any necessary labs or additional diagnostics needed prior to prescribing this medication.
Explain how you might monitor efficacy or side effects of the medication.
Include any additional collaboration or education to others that would be necessary for this patient. Consider family members, home health care, primary care providers, etc.
What would you need to include in your assessment for a patient who may become nonadherent with your prescribing plan for your scenario? What are alternative treatment solutions based upon how you assessed? Describe your new treatment plan.

 

Sample Answer

 

 

 

 

 

 

. Medication Selection & Rationale

Most Appropriate Medication: Lisinopril (ACE Inhibitor)

Rationale: In an elderly patient with cognitive impairment, maintaining stable blood pressure is critical to prevent further vascular cognitive decline. Lisinopril is a "once-daily" medication, which significantly improves adherence in patients with memory issues. It is also renal-protective and does not have the anticholinergic side effects that can worsen dementia symptoms.

Why others are inappropriate:

Propranolol (Beta-Blocker): Generally avoided as a first-line agent in the elderly unless they have heart failure or post-MI. It can cross the blood-brain barrier and cause depression or "mental fog," exacerbating existing cognitive impairment.

Clonidine (Alpha-2 Agonist): High risk for the elderly due to significant orthostatic hypotension (fall risk) and sedation. It is on the Beers Criteria list of potentially inappropriate medications for older adults.