Question

A 78-year-old man presents for a follow-up on hypertension, type 2 diabetes mellitus, and dyslipidemia. His current medications include atorvastatin, telmisartan, hydrochlorothiazide, glipizide, and metformin. For the past week, he has been using over-the-counter medications that claim to "dry runny nose" to treat seasonal allergies. He reports that he now has difficulty with voiding, a dry mouth, and feels unusually "groggy." This is a result of:

The impact of his allergic rhinitis on his chronic health problems.
Drug-drug interactions.
The anticholinergic effect of the OTC medication.
Acute prostatitis

Answer 1

The elder patient's symptoms of difficulty with voiding, dry mouth, and grogginess are due to the anticholinergic effects of the OTC allergy medications he has been using, not his chronic health conditions, other medications, or another disease like acute prostatitis.

Step-by-step explanation:

Understanding the Elderly Patient's Drug Reactions

The 78-year-old man is experiencing difficulty with voiding, a dry mouth, and feeling unusually "groggy" after using over-the-counter (OTC) medications to treat his seasonal allergies. These symptoms are indicative of the anticholinergic effects of the OTC medication, not of drug-drug interactions, the impact of allergic rhinitis on chronic health problems, or acute prostatitis. Anticholinergics can lead to urinary retention, dry mouth, and sedation, particularly in the elderly, who are more susceptible to these side effects. His existing conditions, such as hypertension and type 2 diabetes, coupled with his use of various prescribed medications like atorvastatin, telmisartan, hydrochlorothiazide, glipizide, and metformin, make him more vulnerable to the side effects of additional drugs.

Drug side effects and interactions can compound existing health issues. For example, a drug that increases urination frequency is likely a diuretic, which can be used for treating conditions like hypertension by inhibiting the reabsorption of ions like Na+ and Cl- in the nephron's loop of Henle. Similarly, medications for diabetes, such as sulfonylureas like gliclazide, can cause hypoglycemia as a side effect, leading to symptoms like hunger, sweating, shakiness, and weakness.