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Polypharmacy and Pain Management – Podcast Special!

As a geriatric pharmacist, I understand how difficult it can be to manage polypharmacy and pain management. I had the honor of being invited onto the Pain Pod. This podcast is put together by Mark Garofoli, PharmD, MBA, BCGP, CPE, CTTS. We addressed many different aspects of polypharmacy and pain management in our 40+ minute discussion and I felt that you all might enjoy listening to it. I want to sincerely thank Mark for the opportunity to connect and share some of my thoughts on this challenging conundrum. Here is a list of topics that we covered in his podcast.

  • What was the most interesting patient care concern that you witnessed involving a drug interaction?
  • When providing patient care and educating fellow healthcare professionals, here’s how I usually classify drug interactions, of all types, to digest. How do you recommend folks to best recall drug interactions?
    • Metabolism/Transporters
    • QTc Interval
    • Serotonin
    • Sedation
    • PGx
    • Gender
    • Age
  • What’s your top 5 drug-drug interactions list?
  • I’m constantly told by prescribers that “my people” (that’s us pharmacists) need to lay off on the Serotonin Syndrome worries. I usually explain the whole “I tell people if they feel like they have the flu on Friday, don’t wait until Monday to call someone” version, and that it does happen, yet obviously extremely infrequently. What are your thoughts and recommendations in this regard?
  • Drug interaction software has been observed to flag just about every prescription for interactions (and other clinical concerns) for patients on multiple maintenance medications. An interesting comparison is what I call the Quatro Killer (Opioid, Benzo, Muscle Relaxant, and Hypnotic) when reviewed in Clin Pharm, Micromedex, Lexicomp, & Facts/Comparisons. Recommendations range from “Consider Therapy Modification to “Potentially Severe or Life Threatening” for the same exact drug-drug interactions. What are your thoughts on that type of situation, and do you have any pointers for our audience when navigating the choppy sea of drug interaction flags?
  • What is the deal with grapefruit juice, and what advice to you have for our audience in Florida, and our snowbirds?
  • If you had 5 minutes with President Biden, what would you tell him (or ask him) about pharmacy?
  • OTC medications land folks in the ER at incredible rates, any recommendations for healthcare professionals and patients alike for navigating the OTC analgesic aisle while also utilizing multiple maintenance medications?
  • How do you define pain?
  • What is your favorite pain medication and why? SPOILER ALERT: Find out why I chose tramadol!

I hope you enjoy the podcast titled “PAINFUL POLY PHARMACY” and here is the link to listen!

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