ACUTE DECOMPENSATED HEART FAILURE

PRIME

Pharmaceutical based problem

the dose, route, duration, form, frequency, and timing of the patients regimen
are all correct
drug interactions were found in patients regimen

Risks to Patient
Aspirin is contraindicated to patients who have had gastroesophageal reflux
disease

Interactions
Drugs currently taken by the patient: Fexofenadine, Insulin detemir, Insulin aspart,
Aspirin, Carvedilol, Duloxetine, Futicasone, Lasix, Lisinopril, Meloxicam,
Nitrolycerin, Simvastatin, Ranitidine

Drug-drug
o Meloxicam + Lisinopril NSAIDs may diminish the antihypertensive
effect of ACE inhibitors. A significant decrease in renal function is
also resulted in coadministration of this drugs.
o Aspirin + Lisinopril - NSAIDs may diminish the antihypertensive
effect of ACE inhibitors. A significant decrease in renal function is
also resulted in coadministration of this drugs.
o Lisinopril + furosemide Pharmacodynamic synergism. Although
these drugs are frequently combined together, their effects may be
additive on lowering your blood pressure. Dose adjustment or special
tests may be needed to safely take both medications
o Carvedilol + Meloxicam may increase serum potassium; Combining
these medications may reduce the effects of carvedilol in lowering
blood pressure, especially if meloxicam is used frequently or regularly
(for example, to treat arthritis or chronic pain)
o Aspirin + Meloxicam - increase risk of developing gastrointestinal
ulcers and bleeding
o Aspirin + Carvedilol - aspirin decreases effects of carvedilol by
pharmacodynamic antagonism

Drugs.com: https://www.drugs.com/interactions-check.php?drug_list=243-0,531-
0,949-0,1086-0,1476-0,1549-0,2342-0,2067-0,1146-676
Medscape: http://reference.medscape.com/drug-interactionchecker

Drug-disease/condition
o Aspirin is contraindicated to patients who have had gastroesophageal
reflux disease
Mismatch
Hypertension not controlled despite having regimen of antihypertensives

Efficacy Issues
Uncontrolled hypertension may be due to interactions of certain medications,
i.e. aspirin and lisinopril, where aspirin diminishes the antihypertensive effect
of lisinopril
Patient has been nonadherent to her medication regimen for the past 2 days