[Expert Solution]: Discuss polypharmacy and the mode of…

Discuss polypharmacy and the mode of action of the drugs on the disease on the patient in the case study from adult field of practice . Focuses on two drugs like Tamsulosin and how they work on the disease progression and the competing comorbidities. The role of the prescriber should be explored to address the competency framework for non-medical prescribers. Critically discuss the role of drugs and evidence-based practice of drug treatments in care of clients and associated professional nursing responsibilities and competencies in the field of adult nursing (LO 1) Expand and synthesise knowledge of pharmacokinetics, pharmacodynamics, pharmacogenetics, and lifespan in relation to principles of safe prescribing, drug calculations and administration of drug therapy. (LO 2) Debate the concept of polypharmacy and optimisation and consequences for nursing in relation to acute, chronic and complex multi-morbidities within adult nursing (LO 4) Justify and explain the role of drug development, licensing, pharmacovigilance, reporting and adverse drug reactions (LO 3) Evaluate disease progression and comorbidity complexities within your care settings; the applicability of safe prescribing principles to make informed, rational assessments of an individual’s needs in health and illness including the role of social prescribing (LO 5) Case summary Patient Details · 78yo male, from England . Lives with wife – no services. · Moved to London 6 years ago when fully retired to be closer to family. Current medical history · Chronic lymphocytic leukaemia – Binet stage C – pancytopenia, weight loss, hepatosplenomegaly. · Develops urinary retention · Benign prostatic hypertrophy – awaiting TURP · Hypertension · Atrial fibrillation Results (Blood results etc) FBC · Hb 95g/l · WBC 130 x 10 9/l · Neuts 5.3 x 10 9/L · lymph 121 x 10 9/L · Biochemistry · Na 141 mmol/L · K 4.0 mmol/L · Cl 104 mmol/L · Urea 4 mmol/L · Creatinine 79 umol/L · Albumin 26 g/L · LFTs normal · LDH 380 u/l · CRP 8 mg/L · CT prior to starting treatment (8 weeks earlier) shows splenomegaly of 16cm, mild hepatomegaly only · No significant lymphadenopathy · Bulky prostate · Few small gallstones in otherwise contracted, thin gallbladder · Renal cyst on right side, but otherwise normal Observations: Respirations – 16 breaths/min Spo2 – 97% on air BP – 141/87 HR – 92 bpm Temp. – 36.8 Lifestyle · Normal diet and fluids · Enjoys a daily walk · Retired offshore worker · Non-smoker · Alcohol – only on special occasions · 59 kgs • Penicillin (causes rash) · Current Medication · Obinutuzumab 1000mgs · Venetoclax 50-400mgs (as per protocol) · Digoxin 62.5mcg od · Apixaban 5mg bd · Bisoprolol 2.5mg od · Tamsulosin 400mcg od · Omeprazole 20mg Main complaint/current situation · Noted to have lower abdominal pain, along with reduced/ absent urination · Bladder scan in clinic shows 1400mls post void volume Most Recent Consultations/Follow up · Approach to current medication in terms of immediate management · Approach to chemotherapy both in terms of renal dysfunction, but also with regards to other pre-existing medications – what dose adjustments, drug substitutions should be considered