One of the biggest contributors to polypharmacy isn’t the number of diagnoses a patient has—it’s our mindset around medications that fail to deliver benefit. Everyone knows we need to reduce meds in geriatrics, but how do we do that? Too often, when a drug doesn’t...
Prescribing cascades don’t usually start with “bad” medications. In fact, they often begin with some of our most effective therapies. Metformin, SGLT2 inhibitors, and GLP-1 receptor agonists all have strong outcome data in type 2 diabetes. But when adverse effects are...
In this case scenario, we discuss the “double trouble” of using PPIs and metformin and their effects on vitamin B12. Mrs. J is a 68-year-old woman with type 2 diabetes and gastroesophageal reflux disease (GERD). She has been taking metformin 1,000 mg twice...
In this blog post, I’ll share my top 5 gout pharmacotherapy pearls. This can often show up in practice as well as on those challenging board exams! Allopurinol Doesn’t Treat Flares Allopurinol reduces the production of uric acid. Because of this mechanism,...
Mr. H is a 78-year-old male presenting to a primary care clinic for a routine medication review. In this scenario, we want to identify deprescribing targets. His past medical history includes hypertension, heart failure with preserved ejection fraction (HFpEF),...
