Discussion – Primary Care Medication Management
Criteria, first published in 1991 by the American Geriatrics Society, is a list of medications that have a high risk of harm as compared to the potential benefits. It is also a list of drugs with high risk and drug interactions to evade and detect agents necessitating renal dosing adjustment. These criteria are relevant in reducing the inappropriate use of medication through the identification of medications that are associated with health matters such as falls, confusion, and mortality that are avoidable when prescribing or considered for stopping. The rationale of these criteria is to reduce the potential risk of complications in older patients as a result of improved prescription practice for old patients (Alsuwaidan et al., 2019).
Many drugs’ pharmacokinetics in children are different as compared to adults. The lack of enough studies on pharmacokinetics in children has resulted in difficulties in the calculation of drug dosage in children. However, the dosage of a child is always based on age and weight. Therefore, when prescribing a dosage for a pediatric, it is recommended to use an appropriate pediatric dosing reference source such as AMH children’s dose companion (O’Hara, 2016).
The most sensitive period of pregnancy is during the embryonic period. This period occurs between the implantation and approximately 60 days post-conception. It is at this period that the pregnancy is most sensitive to teratogens, and any exposure to such agents can lead to a greater risk of fetal malformation (Alwan, and Chambers, 2015).
Approximately 80% of patients or higher occasionally miss out on their medication dose. The type of medical half-life that will be beneficial to a patient who at times forgets to take his medication is with a long life, as they always tend to create fewer problems when a dose is missed as compared to those with a short half-life (Hallare, and Gerriets, 2020). A patient who is on the highest daily dose of his medication with no desired effect of the medication is likely to be on an ultra-rapid metabolizer with the medication.
As you get older, it is imperative to know that increased use of medication in old age in association with the normal body changes caused by aging increases the risk of unwanted/harmful drug-food interactions. These drug-food interactions in the elderly are warfarin and vitamin K, insulin and alcohol, digoxin and high fiber diet, statins, calcium channel blockers, erectile dysfunction drugs, grapefruit, acetaminophen and alcohol, antibiotics and dairy products, antithyroid drugs, and iodine-rich foods.
References
Alsuwaidan, A., Almedlej, N., Alsabti, S., Daftardar, O., Al Deaji, F., Al Amri, A., & Alsuwaidan, S. (2019). A comprehensive overview of polypharmacy in elderly patients in Saudi Arabia. Geriatrics, 4(2), 36. https://www.mdpi.com/462604
Alwan, S., & Chambers, C. D. (2017). Identifying Human Teratogens: An Update. Journal of Pediatric Genetics, 4(2), 39–41. https://doi.org/10.1055/s-0035-1556745
Hallare, J., & Gerriets, V. (2020). Half Life. https://europepmc.org/article/nbk/nbk554498
O’Hara, K. (2016). Paediatric pharmacokinetics and drug doses. Australian prescriber, 39(6), 208. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5155058/
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Question 
Primary Care Medication Management
Discussion Prompt
Post your answers to the 6 questions corresponding to this week’s content on primary care medication management. Provide your responses and rationales. Support your rationales with high-level evidence. (See Post Expectations)
PHARM W1-Primary Care Medication Management
- What is the Beer Criteria, and what is its significance in prescribing?
- What is the safest method of calculating a medication dose for a pediatric patient?
- At what time period in pregnancy can medication potentially have the greatest risk of causing malformations?
- If your patient sometimes forgets to take her medication, what type of medication half-life would be beneficial?
- Your patient is on the highest daily dose of his medication, and it is not giving him the desired effect. What type of metabolizer is he with this medication?
- What food item interacts with many medications and should be asked about its ingestion, especially in the elderly?
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years