The nurse who is admitting an older adult to the medical-surgical unit is taking a drug history. The patient lists his daily and as-needed medications and relates very detailed information. The nurse is surprised at the depth of information the patient provides about the medications. The list of medications includes digoxin 0.125 mg/day, aspirin 325 mg/day, nifedipine (Procardia) 30 mg/day, spironolactone (Aldactone) 25 mg/day, atorvastatin (Lipitor) 10 mg/day, cimetidine (Tagamet) 10 mg/day (OTC), and cyclobenzaprine (Flexeril) 5 mg as needed.
1. What concerns would the nurse have about these medications considering the patient’s age?
2. What type of chronic illness does this older adult have, and what do these medications do for the symptoms?
3. The patient asks, “I’ve always wanted to ask why the nurses ask if I drink grapefruit juice. Why is that such a big deal?” What will the nurse tell the patient?
4. What are three examples of drugs whose metabolism would be affected if the patient drinks grapefruit juice?
5. The patient asks for examples of other substances that can alter drug levels in the body. How will the nurse answer?
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