Medication Reconciliation Reflection

I chose to perform my medication reconciliation on an elderly female patient with a pretty minimal medical history. This patient was taking a total of six medications. During the interview process, it was evident that the patient had a good knowledge basis for each of her medications regarding their use, dose, and frequency. This was reassuring for patient safety and medication adherence. 

As I began researching this patient’s medications I was quite surprised to see the number of possible interactions, side effects, and safety concerns. One of the bigger concerns I noted from this process was the hepatic effects of many of this patient’s medications. Given the patient’s older age and her daily alcohol consumption, I was concerned for hepatic impairment. This patient does have yearly lab work done, however she could not confirm as to whether liver function tests are a part of this testing. 

Another notable finding was the contraindications of common over the counter drugs with many of her medications. NSAIDs, such as aspirin and ibuprofen, should be avoided with this patient’s current medication regimen due to possible adverse effects as well as decreased efficacy. The patient was not aware of this and noted that she oftentimes does take ibuprofen for generalized aches and pains. Interestingly enough, arthralgias and myalgias are a very common side effect of one of her medications. I advised that she discuss this further with her provider to discuss possible medication changes as well as an alternative treatment for her arthralgias. 

The process of medication reconciliation was very insightful as a future nurse. Although this patient was only taking six medications, there was a substantial number of possible adverse effects and contraindications. From my experience thus far, I know that this patient does not fit the norm for her demographic. Many patients have a much longer list of medications and therefore have an increased likelihood for possible adverse effects, which is a major safety concern. As a future nurse, I will continue to remind myself that medications, although intended to be beneficial, can be very harmful to the patient.