Case Study 1
Treatment of the 75-year old with desipramine, diphenhydramine, and hyoscyamine is responsible for the memory problems and disorientation that the patient is suffering from. The similarity between the three drugs is that they are anticholinergic, which has the effect of reducing cognitive and physical activity as well as dementia in the patient. Also, anticholinergics cause delirium and hallucination which may be contributing factors for disorientation and worsening memory problems. The mode of action of these drugs is characterized by blocking the acetylcholine neurotransmitter during the passing of chemical and electrical signals in the peripheral as well as the central nervous system. As such, parasympathetic nerve impulses are blocked from their receptor nerve cells. The parasympathetic system has nerve fibers that make it possible for smooth muscle's involuntary movement in the body. Therefore, the inhibition of nerve impulses makes it impossible for smooth muscle's involuntary movement resulting in disorientation and the worsening of memory in the patient.
Case study 2
Benzodiazepine may have resulted in disorientation in the patient, noting that the drug has an effect on gamma-aminobutyric acid, which is a critical neurotransmitter in the brain. The neurotransmitter inhibits motor neurons whose effect is slowing down the neuronal activity throughout the body thus explaining the potential of the drug to cause disorientation in the patient.
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Age causes changes in the absorption, excretion, metabolism, and distribution of many drugs in the body. In the case of the 75-year-old man, his age affects the drug metabolism noting that the medication will have half-lives of up to ninety-six hours.
As noted earlier, the medication provided for the patient are responsible for the side effects experienced by the patient. In efforts to avoid the side effect, the physician may make changes to the medication and prescribe gemfibrozil 600mg twice per day for hypercholesterolemia, verapamil180mg once per day for hypertension, and dabigitran 110mg twice per day for atrial fibrillation.
