Clinical Neurology and Neurosurgery

Running head: RISKS ASSOCIATED WITH MEDICATION USE 1
Risks Associated With Medication Use
Student Name
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Question 1
Medication use is the most common form of treatment used by healthcare professionals
in the management of severe to serious client conditions. Medications lead to an improvement in
the quality of life and healing from conditions when administered correctly and in the right
dosages. Some medicines, however, can cause unwanted effects to the patients if incorrectly
administered or if given in wrong doses. Some medications can just react with the immune
system and cause adverse effects, even if given in the right doses (Vasconcelos, Aurenção,
Alvarenga, & Thuler, 2020). Nurses are responsible for the administration of medication in the
healthcare set up. Nurses administer different medications to all patients according to the
prescriptions; hence, they have a responsibility to their patients to be aware of medical
indication, dosage, side effects, and drug interactions of all medications. They also have a role in
the course of action in case the patient experiences unwanted drug effects to prevent further
complications. The use of drugs has potential risks that can affect the individual prolonging
hospital stay.
The risk of bleeding is one factor to be considered for Mr. Michael due to the medication
prescribed and his previous medical history. The patient has hypertension, congestive heart
failure, and atrial fibrillation. Currently, the patient has been put on warfarin, clarithromycin,
benzylpenicillin, spironolactone, ramipril, and bisoprolol. Drug interactions can be a cause of
the increased risk of bleeding. Clarithromycin, an antibiotic, interacts with warfarin when
administered together. Warfarin is broken down by the cytochrome p450 enzyme for excretion
from the body. Clarithromycin inhibits the enzyme cytochrome p450 hence increasing the
availability of warfarin in the body the anticoagulant effect is prolonged and might be amplified
following the next administration of warfarin (Quinn, Liko, & Lee, 2017). This increases the

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INR and can lead to severe bleeding during minor procedures such as cannulation.
Administration of spironolactone together with warfarin lowers blood coagulation since the
diuretic effect of spironolactone leads to the accumulation of anticoagulation factors hence the
blood-thinning effect, thus leading to increased risk of bleeding (Yukari Cheno, Cagnacci
Cardilli, & Kobayashi, 2019). Benzylpenicillin alters the platelet function hence leads to
increased anticoagulation in the blood.
Underlying conditions and extremes of the age of a patient increase the risk of bleeding
in patients with the administration of medication. Mr. Michael is 84 years old with hypertension,
congestive heart failure, and atrial fibrillation. The presence of hypertension in a patient makes
him vulnerable to vessel breakage and leading to bleeds. In a scenario of rupture of blood vessels
accompanied by warfarin, use can lead to massive bleeding in the body hence increased risk.
Hypertension is the primary cause of hemorrhagic cause in patients, and the risk is more when
the patient is using warfarin, an anticoagulant (Rivera-Lara et al., 2018). Congestive heart failure
with arterial fibrillation is a significant risk factor in systemic bleeds, and warfarin is prescribed
to prevent the risk of clots in the heart that may result due do atrial fibrillations. The combination
increases the risk of bleeding (Faza et al., 2017).Mr. Michael is elderly; the rate of drug
breakdown is slow in the aged due to the wearing out of organs. Older people are also prone to
falls and minor injuries. The use of a blood-thinning agent can lead to severe internal or external
bleeding after small falls.
Risk of hypotension is another risk to be considered for the patient due to the medications
prescribed, their interactions, and the age of the patient. Ramipril, a drug prescribed for the
management of congestive heart failure, has hypotensive effects. It is an angiotensin-converting
enzyme inhibitor that relaxes blood vessels hence lowering blood pressure (Juraschek, Appel,