This medication reconciliation has taught me a lot about the process, as well as beginning to think like a nurse and address specific concerns about medications for a patient. For this specific patient, I noticed a few substantial safety concerns, specifically related to the patient’s diabetes. A good amount of the medications the patient was on, had the potential to interfere with blood glucose levels significantly. This raised some concern for me, as they already have issues with maintaining adequate levels of blood glucose. The medications that posed the most safety concerns to me were the Prozac and Atenolol. Prozac in addition to potentially altering blood glucose levels, has the possibility of exacerbating the symptoms of depression and anxiety, and can lead to suicidal thoughts and ideation. 

The patient had a basic idea of why they were taking each medication, with the exception of aspirin. It is very important for the patient to know the reason they are on a medication because if they don’t, there could be an increased risk for them to discontinue taking the medication, as they would not know the purpose for taking it in the first place. In addition, the patient needs to know the purpose of each medication because it could prevent potential and serious drug to drug interactions from occurring.

The patient is not currently taking any two medications that act on the same pathway. In certain instances, when a patient takes two or more medications acting on the same pathway, there can be exacerbation of the patient’s symptoms in a negative way, or there could be some drug to drug interactions that could occur. Hypothetically, if the patient was on two medications that virtually did the same thing, I would advise them to discuss it with their provider as it could have been an oversight. The medications the patient is on, such as the Prozac, if they were prescribed with another antidepressant, the drugs could interact and make symptoms worse. If the patient was prescribed another beta blocker, such as the Atenolol, there would be a potential for serious cardiac arrhythmias, because there would be a lot of suppression on the cardiac beta cells. Another example would be taking aspirin and some sort of NSAID or anti-inflammatory, as it could decrease the effectiveness of the aspirin or cause GI bleeding. 

I was not able to discuss the serious safety concerns regarding the patient’s medications with them. Hypothetically if I did, then I would discuss the concerns of Atenolol and Prozac with the patient’s diabetes. I would also advise them to routinely self-check their glucose levels in case they were not able to recognize the symptoms of hypoglycemia or hyperglycemia due to the beta blocker they’re on.