When I’ve had students with me, they will often ask about multiple serotonin related drugs and risk of serotonin syndrome. A classic example of this is a patient on an SSRI and Tramadol. This combination is used frequently in practice. Serotonin syndrome is...
88 y/o female who’s had some difficulty with pain management. She was on scheduled Tylenol (acetaminophen) 1,000 mg twice daily as well as Ultram (tramadol) 50 mg every 6 hours as needed. She had brought up the complaint about her osteoarthritis to her...
A 68 year old female was having difficulty with some anxiety throughout the day but more problematic to the patient was that she could not sleep at night. Multiple different non-drug interventions were tried, but none seemed to make any difference. Trazodone was...
Weight loss in the younger population generally tends to be less of a problem than weight gain (with the exception of eating disorders etc.). However, in the elderly there are definitely situations where weight loss can be problematic. In these instances we must...
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...
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...
