Counteracting drug effects are all too common in geriatric and polypharmacy patients. I wanted to share common examples that I’ve seen in my practice as a clinical pharmacist. NSAIDs vs. AntihypertensivesCase: A 68-year-old man with hypertension controlled on...
Digoxin is a cardiac glycoside that has a narrow therapeutic window. Because of this, we typically monitor digoxin levels. If levels get too high, we can run into adverse effects. In some cases, particularly geriatric patients, those adverse can be misinterpreted as...
Deprescribing is an important part of care for hospice patients. The main goal of hospice care is to focus on comfort care rather than curative treatments, which means evaluating if a patient’s current medications are still indicated, effective, safe, and convenient....
In this case, I outline a unique situation involving stimulants and elderly patients. I outline some of the potential complications and contributions to the prescribing cascade. A 76-year-old female resides in an assisted living. She has a history of ADHD, anxiety,...
I have had plenty of opportunities in my career to review medications with patients and offer solutions to help reduce their pill burden. Keeping track of taking all these medications can be a full-time job for some of our patients. It is critical that we try to...
As a geriatric pharmacist, I’m always on high alert for the prescribing cascade. I outline my top 5 examples of the prescribing cascade in diabetes care in this article. Metformin and Loperamide Metformin has been the go-to first-line agent of choice for years....
