During the process of writing the medication reconciliation I did notice some safety concerns for some, if not all, of the medications. Most of the safety concerns had to do with the adverse effects that was associated with them. Some of these included mild adverse effects that were seen in all four of these medications such as dizziness, nausea and vomiting. Other adverse effects that were more severe that were safety concerns included things such as hyperglycemia, heart failure, and strokes. Another major safety concern that I noticed with one of the medications was that it was contraindicated to take it for atrial fibrillation. This was concerning because my patient did have atrial fibrillation, and even thought they were taking it because of atrial fibrillation. Other safety concerns that I noticed was some drug-to-food interactions such as milk and alcohol. This set off an alarm for me because I knew my patient was consuming these things multiple times throughout the week while taking the medication even though it is recommended not to.

 I would say that these safety concerns were in no way due to their age or ability to understand their medications, as their mental state is intact. When I interviewed my patient about each medication, they were confident in explaining what each medication was for, and what it did to help them. The only medication that was off was their description of Flecainide. It was partially right but some things they said, as I mentioned earlier about it contraindicating with afib, did not match up. It is important that they know what each medication is for because it can impact the things they do, eat, drink, and influence their health status. In general, the more knowledge they have about their medication, the better they can manage their health as a whole.

Two medications that did very similar things were Lisinopril and Metoprolol. These were both antihypertensives. My patient did report being quite hypertensive so it was not a surprise for them that they were on two antihypertensives but they didn’t know exactly why they needed two separate medications for their high blood pressure. The patient was also unaware that the two medications had a drug-to-drug interaction, as taking both can increase hypotensive effects. They were also unaware of interactions that had to do with the milk and alcohol as mentioned before, and the consumption of potassium-containing salt substitutes.