Chronic Medical Conditions and Health Surveillance Essay

Chronic Medical Conditions and Health Surveillance - Essay Example In order to control her blood pressure, she was started on an antihypertensive. The patient then sustained a fall which was not accompanied by any episodes of altered consciousness. Falls are a commonly encountered issue amongst the elderly and studies have revealed that they amount to almost 60% of the hospital admissions in the UK National Health Service (NHS) amongst the elderly (Oliver, 2007, p. 173). In order to decipher the cause of the fall, a focused history regarding the events preceding and following the fall should be obtained. In the case of this patient, she reports that the fall occurred when she stood up from a chair and was preceded by an episode of feeling ‘giddy’. Since she denies any aura, alteration of consciousness, post-ictal events, persisting weakness or loss of function in any part of the body after the fall, and this is verified by her husband who was present at the time of the incident, most common neurologic causes of the fall such as stroke o r seizures can be ruled out. Similarly, as she denies any chest pain or palpitations, cardiac causes such as arrhythmias and angina/myocardial infarction also become unlikely as the cause of the fall. ... system covers the commonest causes of falls amongst the elderly, whereby D refers to Drugs and alcohol; A refers to age-related physiological changes, such as impaired balance and postural instability, reduced vision and increased reaction time; M refers to medical causes and E refers to environmental causes (Oliver, 2007). Drugs/medications are amongst the top causes of falls amongst elderly especially due to the multiple co-morbidities that are commonly found amongst elderly patients, the problem of poly-pharmacy leading to drug interactions is quite common in this population of individuals. Therefore, obtaining a careful drug history and ruling out any drug over dosage, interactions and adverse effects leading to a fall is important in elderly patients. A critical analysis of the patient’s medication history reveals that the patient was started on Atenolol, at a starting dose of 400mg BID, which amounts to 800mg of Atenolol per day. Atenolol belongs to a class of anti-hyper tensives termed as beta blockers, and is one of the most commonly prescribed drugs from this class (Carlberg, Samuelsson, & Lindholm, 2004, p. 1684). Atenolol is a cardio-selective beta blocker, i.e. it only acts on beta-1 receptors, which are the predominant type of receptors in the heart. Such beta blockers spare the beta-2 receptors, which are the predominant type of receptors located in the lungs and the vascular smooth muscle and are thus free from side effects such as bronchospasm, which were previously commonly encountered with the use of non-selective beta blockers (Medic8, 2010). Previously, beta blockers such Atenolol were considered to be the first-line agent in the management of hypertensive patients, but more recently, the use of these agents as the drug of choice for hypertension