I had a patient who was rehabbing a knee replacement, and having some difficulty sleeping. Pain was a contributing factor, but appeared to be pretty well managed and eventually determined to not be a factor in this case. I had discussed the case with nursing, and they...
I’ve had a request to cover some Digoxin – Digoxin can be a challenging drug at times. If a patient is elderly, this can really complicate things. Another thing that can complicate Digoxin dosing is renal function – which obviously usually declines with age, leading...
Patient had a recent seizure thought to be due to not taking their Xanax over a period of a few days. The individual apparently had a seizure history in the past, but this was not clear in the medical records. This patient ended up getting hospitalized due to the...
In making some of these decisions about medication changes, there isn’t always a perfect answer, and people disagree, but I didn’t write this post to tell you that people disagree – hopefully most of you have figured that out by now! Anyway, here’s a brief overview of...
In just one more example of the prescribing cascade, I had a resident at a nursing home that was prescribed Lexapro for depressive and anxiety type symptoms. A few weeks after starting this medication, the resident had worsening confusion, change in cognition, and was...
In geriatrics, I see frequent use of acteylcholinesterace inhibitors for dementia. Some examples include: Aricept (donepezil), Exelon (rivastigmine). One of the hallmark side effects of this class of dementia drugs is GI symptoms and weight loss. Nausea, loose stools,...
