RECENT ASSIGNMENT

MULTIPLE MEDICATION MANAGEMENT ASSIGNMENT
You are an accredited MUR pharmacist and Dr AS. Khalid has requested a Medication Management Review for Mr Ali Al Shamsi
Patient Details
Name: Mr Ali Al Shamsi Date of Birth: 04/02/46
Address: 123 Central Avenue; Abu Dhabi Date of Referral: 14/02/21
Referring GP: Dr Khalid Date of Interview 15/02/21
Sex: Male Weight: 79kg Height: 179 cm
Patient Information
Allergies or adverse reactions: Keflex
Smoking: ex-smoker was 20/day. Stopped 15 years ago
Alcohol: None
Influenza vaccine: 2019, Pneumococcal?
Patient History (Social/Medical)
Medical diagnoses:
? GORD
? Hyperlipidaemia
? Type 2 diabetes mellitus
? Hypertension
? Asthma
At the interview the patient says he has not had an acute asthma attack for past 3 years. The main trigger for an asthma attack is a heavy cold. He does not have a ‘reliever’ medication on hand and does not use a spacer. He lives with his wife and enjoys going out for meals and on overseas holidays.
Mr Ali does not routinely test his blood sugar levels. On questioning he experiences frequent attacks of excessive sweating and feels shaky This occurs around 2 or 3 times a week but is OK when he has something to eat.
On questioning he brings out a bag with a few other medicines Temaze10mg, Panadol Osteo 665mg. Panamax 500mg, Glucosamine sulphate 500mg, Fish Oil 1000mg and Mobic 15mg . He says he takes Panadol Osteo two in the morning and two after dinner at night. He takes the Mobic when his knees are painful. The Temaze he says he uses about once a week but is having trouble sleeping at present. Sometimes he will take two Panamax if he cannot sleep. He takes the glucosamine one or two from time to time if his knees are bad and fish oil every day .
Reason for Referral
5 or more medications
? compliance
Other medicines?
Current Medications
Medication Dose Purpose
DBL Aspirin 100mg 1 mane
Daonil 5mg 1 bd Diabetics
Esomeprazole 20mg 1 bd GORD
Natrilix SR 1.5mg 1 mane hypertension
Simvastatin 20mg 1 daily cholesterol
Coversyl 10mg 1 daily blood pressure
Seretide MDI 250mcg/25mcg 1 bd Asthma (25 micrograms of salmeterol and 250 micrograms of fluticasone propionate.)
Relevant Test Results
Recent BP 14/02/21: 140/85mmHg,
Results from September 2020: HbA1c 7.2%, Total cholesterol 4.8mmol/L, HDL 0.9mmol/L ( L) Triglycerides 1.6mmol/L; Sodium 143mmol/L Potassium 3.4mmol/L
SrCr 88micromol, eGFR 62mL/min
Question:
1. Write a letter or report to the Doctor, outlining your key findings for this patient and your suggestions or recommendations to the prescriber (Maximum 1500 words).
NB
• Do not forget appropriate references
• Please place your name first name first then surname and student number on the top of each page in the header