Mr. Park, 85, recently was admitted to the hospital with community-acquired pneumonia and, after five days of intravenous antibiotic therapy, he was discharged home.
Mr. Park lives with his daughter. He has hypertension, benign prostate hyperplasia and mild Alzheimer's disease. His medications at home included bisoprolol/HCTZ, 5/6.25 mg; tamsulosin, 0.4 mg; and donepezil, 10 mg once a day. While he was in the hospital, the bisoprolol was switched to 50 mg of metoprolol twice a day because bisoprolol was not on the formulary. At the time of his discharge, an intern reviewed his hospital medication list and wrote out the prescriptions, which were given to Mr. Park by a nurse. Mr. Park's daughter filled the new prescriptions. When he returned home, Mr. Park resumed taking his usual medications, plus the new ones prescribed in the hospital. The combination of bisoprolol and metoprolol made Mr. Park bradycardic and dizzy. He fell on his way to the bathroom. When the emergency medical technicians arrived at his home, his heart rate was just 38 beats per minute. Mr. Park was readmitted to the hospital.
Patients often are discharged from the hospital to their homes unprepared to care adequately for themselves. Because of postdischarge missteps, many involving a medication mistake, patients too often may find themselves back in the hospital. Given the medications Mr. Park was mistakenly taking after he returned home, his dizziness and bradycardia could have been predicted and his readmission avoided.
This article provided by American Medical News. To read the entire article, please click here: AMA
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