pharmacy case study help?

i just dont know where to begin. plz help
Scenario #3
Mr. SF is a 78-year-old Caucasian male who has been experiencing memory decline for the past 2 years. His medical conditions include glaucoma, depression and osteoarthritis. His current medications include Aricept 5mg one tablet at bedtime (started 8 weeks ago), Fluoxetine 20mg one tablet in the morning at 10 AM (started 10 months ago), Xalatan 1-2 drops in each eye at bedtime, enteric-coated aspirin 325mg one tablet at 8 PM, Zyprexa 20mg one tablet at 8 PM (started 4 weeks ago). He has not taken any of the other memory enhancing medications. He is allergic to penicillin. He does not drink or smoke. He denies taking any herbals and over-the-counter medications. His wife administers all of his medications. His wife tells the physician today that she has noticed an improvement since he started the Aricept but that he often complains of not feeling rested when he wakes up and he also recently complained of having difficulty swallowing his pills. During the treatment plan meeting the physician asks for your recommendations with regards to any changes you would like to see implemented in the patient’s medications to resolve his fatigue and dysphagia. What would you recommend for this patient? Remember to be specific!

You give him what the doctor orders. If you feel that it is not the correct drug through your knowledge that consult with the doctor.

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