Availability of Critical Medicines During Pandemics
The patient has been diagnosed with five medical conditions (peptic ulcer, anxiety, iron deficiency anemia, asthma and depression) for which she is receiving treatment that includes a combination of prescription medication, supplements and herbal concoctions. She takes St. John’s wort for the depression, iron pills for iron deficiency anemia, alprazolam (Xanax) for anxiety, prednisone and albuterol for asthma, and esomeprazole for peptic ulcer. In addition, the patient regularly drinks alcohol in moderated amounts of between 2 and 3 cans daily. The patient reports back after three months that although one of her medical conditions is well controlled, she is experiencing some side effects. In addition, she is reporting some side effects to include severe fatigue, shortness of breath, dizziness, and swelling/soreness in the tongue. The patient’s asthma condition is well controlled, and this is likely caused by increased drug availability. She regularly takes one medicine for asthma and occasionally takes another medicine for the same condition. The drug availability is improved as the two drugs work complementarily so that more active drug sites are bound to improve the effects. While the drug availability for the asthma medication has been improved so that the condition is alleviated, the same cannot be said for the other medical conditions. This implies that even when taking the medication for three months as recommended, there has been no positive changes noted in the other four medical conditions (Preston, 2019). In fact, the lack of positive changes on the other medical conditions is likely due to decreased drug availability as the other pharmaceutical interact and compete for the same active binding sites. Besides that, the presence of alcohol could moderate the effects of the drugs while causing some of the side effects noted. Additionally, the herbal supplement may have a moderating effect on the other medication. Given this awareness, there is a need to eliminate alcohol consumption and review drug interactions in order to develop a more effective prescription with positive effects on the medical conditions and minimal side effects (Zhou & Meibohm, 2013). Availability of Critical Medicines During Pandemics
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Preston, C. (2019). Stockley’s Drug Interactions: A Source Book of Interactions, Their Mechanisms, Clinical Importance and Management (12th ed.). Pharmaceutical Press.
Zhou, H., & Meibohm, B. (Eds.) (2013). Drug-Drug Interactions for Therapeutic Biologics. John Wiley & Sons, Inc.
In this case study, the patient is a 60-year-old woman with the medical conditions as below:
Iron deficiency anemia
The drugs taken by the patient for specific conditions were provided as below:
Depression – St. John’s wort (an Herbal supplement)
Iron deficiency anemia – Iron pills
Anxiety – Alprazolam(Xanax)
Asthma – Prednisone (Regular) and Albuterol (occasionally)
Peptic ulcer – esomeprazole
In addition to that, the patient used to take 2 to 3 cans of beer daily.
Three months later,
The patient has experienced the side effects as below:
Shortness of breath,
Swelling/soreness in the tongue.
however, the asthma condition got controlled effectively.
Cause of increased drug availability:
In this case, there was an increased drug availability for asthma, where Prednisone is used regularly, however, got improved by the occasional use of Albuterol.
Note: Drug availability is considered as the rate of drug that gets access to the site of action, which can be either by repeated administration of the same drug or by the presence of the same compound in two different drugs.
The reason for prescribing Albuterol would be due to its parenteral administration (in mucous membranes), which can increase the drug availability when compared with oral administration.
Interactions that decrease drug availability :Availability of Critical Medicines During Pandemics
The intake of alcohol leads to its interaction with Metronidazole and causes adverse effects nausea, abdominal discomfort, vomiting, etc., where the drugs will be flushed out of the body.
It may reduce the availability of drugs, for example, Xanax should not be taken along with herbal supplements ,it would reduce the drug intake by the cells and creates adverse effects.
St. John’s Wort could reduce the plasma concentration of many drugs.
Causes of decreased drug availability:
Because of interactions, as explained earlier, the availability of drugs to the cells gets decreased, which causes the side effects(mentioned earlier) experienced by the patient after three months.
Recommendations for the co-administration of all medications:
Intake of alcohol should be avoided during medications so that its interactions with the drugs can be avoided.
The patient should be transparent to provide all details of the past medical history and the intake of any herbal supplements so that its adverse effects can be avoided.
The drugs should be followed with appropriate guidelines(start, stop, food intake, etc.) as prescribed by the physician.Availability of Critical Medicines During Pandemics