[Solved]: Day 1 on admission: John, a 70-year-old male, was…

Day 1 on admission: John, a 70-year-old male, was admitted with a wound infection on his right leg and was started on IV antibiotics in the emergency department before being transferred to the medical ward. John has a past medical history of DVT in his left leg and is a heavy drinker. He has been referred to the drug and alcohol team during this admission. His current condition shows good oral intake, regular bowel motions, and voiding well. Day 2 admission: At 1:20 am, John requests Endone PRN for severe pain, grimacing, groaning and moaning. Day 3 Admission: John reports coughing up blood and noticing blood in his stool. Benzylpenicillin 1.2 g IV for 3 days (then later changed to Flucloxacillin 500 mg PO) Clexane 80 mg SC once daily Endone 10 mg PO QID (PRN) – Max 40mg/24 hrs Ibuprofen 400 mg PO TDS Diclofenac 25 mg PO TDS Allergy: Ceftriaxone Question 1 – Discuss the pharmacokinetics (ADMEs) and pharmacodynamics of Benzylpenicillin and Clexane in relation to John’s condition, age, and history as a heavy drinker. Highlight potential medication safety concerns and how they could be mitigated. Question 2 – Comment on the drug-to-drug interactions in this scenario. Is it safe to administer and why? Ibuprofen and Diclofenac? Enoxaparin and Diclofenac? Benzylpenicillin and Diclofenac? Question 3 – Observe carefully John’s antibiotic regime and analyse the reasoning behind the change from Intravenous administration to oral administration taking into consideration the ADMEs (absorption, distribution, metabolism, excretion) QUM, lifespan issues and medication safety. Question 4 – This question relates to patient’s request on day 2 of admission (refer to scenario) What is an appropriate nurse response in this situation? And why? Question 5 – As a student nurse please provide four (4) medication education points that are relevant to the patient’s scenario and the rationale for these education points. Question 6 – Based on the patient’s progress in day 3, which medications should be withheld? and why?