Patient drug history medications

Select When pharmacotherapy is necessary, and after review of an individual patient s history, medical status, presenting symptoms, and current drug regimen, the clinician chooses the best drug regimen among available therapeutic options. 

Patient Drug History Versus Patient Medical History... 

The medical record is another source of medication and health-related information. Access to this record may be limited in certain practice settings however, it can be a valuable tool to review prior to conducting your patient drug history interview. Some practitioners use medical release forms to obtain medical record information such as laboratory data from other institutions required for drug therapy monitoring. 

Many patients rely on a caregiver or family member to assist them with their medications. These individuals can be a valuable source for patient drug history data. ... 

Conduct a medication history (prescription, over-the-counter, and dietary supplements) to determine conditions or causes of hypertension. Does the patient take any medications, supplements, herbal products, or foods that may elevate SBP or DBP Does the patient have drug allergies ... 

When designing a drug regimen for treatment of IBD, several factors should be considered, including the patient s symptoms, medical history, current medication use, drug allergies, and location and severity of disease. 

The drug of choice for chronic hepatitis B depends on the patient s past medical history, aminotransferase level, HBV DNA level, and most importantly, HBeAg status. 

Persons with confirmed chronic hepatitis B should be evaluated for treatment, which may include interferon, pegylated interferon, lamivudine, adefovir dipivoxil, or entecavir. The drug of choice for chronic hepatitis B depends on the patient s past medical history, aminotransferase level, HBV DNA level, and most importantly, HBeAg status. 

Obtain a thorough history of prescription, non-prescription, and natural drug product use. Is the patient taking any medications that could contribute to cognitive changes in the elderly ... 

Obtain a thorough medication history, including use of prescription, non-prescription, and complementary and alternative drug products. Determine which, if any, treatments in the past had been helpful as judged by the patient. Could any of the patient s current medications be contributing to Ul ... 

Before administering any medication, take a thorough drug history to establish any past allergic or adverse reactions experienced by the patient. 

Evaluation of the anxious patient requires a complete physical and mental status examination appropriate laboratory tests and a medical, psychiatric, and drug history. 

Factors that influence the choice of antidepressant include the patient s history of response, history of familial response, concurrent medical conditions, presenting symptoms, potential for drug-drug interactions, comparative side-effect profiles of various drugs, patient preference, and drug cost. 

Seizures Methylphenidate may lower the convulsive threshold in patients with history of seizures, in patients with prior EEG abnormalities in the absence of a history of seizures, and, very rarely, in the absence of a history of seizures and no prior EEG evidence of seizures. In the presence of seizures, discontinue the drug. Hypertension and other cardiovascular conditions Use cautiously in patients with hypertension. Monitor blood pressure at appropriate intervals in all patients taking dexmethylphenidate, especially those with hypertension. Caution is indicated in treating patients whose underlying medical conditions might be compromised by increases in blood pressure or heart rate (eg, pre-existing hypertension, heart failure, recent Ml, hyperthyroidism). 

With drugs that produce a depression after chronic exposure (e.g., alcohol), detoxification is instituted, in addition to supportive care and therapy for substance dependency. Even though most alcoholics will experience depression immediately after the cessation of heavy and prolonged consumption, the majority will remit within several weeks following detoxification and supportive care (see Chapter 14, The Alcoholic Patient ). For those who do not, it is likely there had been a preexisting depressive disorder, which itself can lead to substance dependency, because patients frequently self-medicate before seeking professional intervention. This possibility should be evaluated through a review of the patient s personal medical and psychiatric history, as well as family history. 

Age of patient Past medical history Comorbidities Drug history Concomitant medications Allergies... 

Patient 1 is an obese 45-year-old with raised transaminases which were discovered on admission to hospital with a chest infection. There is no past medical history or drug history of note. Investigations were undertaken for hepatitis. 

Other measures include the clinician s global assessment based on the patient s history of activities and limitations caused by OA, the Western Ontario and McMaster Universities Arthrosis Index, Stanford Health Assessment Questionnaire, and documentation of analgesic or NSAID use. Patients should be asked if they are having adverse effects from their medications. They should also be monitored for any signs of drug-related effects, such as skin rash, headaches, drowsiness, weight gain, or hypertension from NSAIDs. 

An essential preliminary step to prevent adverse drug-drug interactions is to obtain a comprehensive list of medications that a patient is taking. Unfortunately, there maybe difficulties in taking an accurate drug history, often due to lack of time and especially when patients also take traditional/natural remedies, OTC drugs and nutrients, which patients often consider as unimportant to reveal. 

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