In this case scenario with gabapentin and metolazone, I lay out how the prescribing cascade can rear its ugly head. SK is a 74-year-old male with a past medical history significant for chronic kidney disease stage 3, type 2 diabetes, hypertension, peripheral...
Every so often, you see a medication order that just makes you tilt your head and think, “Huh?” One order that I recently encountered that made me scratch my head was (ferrous sulfate) iron 2 tablets once daily. On the surface, it’s straightforward – take two tablets...
Nitrofurantoin is often used in patients for UTI prophylaxis. One potential concern with nitrofurantoin use is pulmonary toxicity. This can often be overlooked in patients as a potential cause of respiratory problems. Here’s a case scenario where nitrofurantoin...
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...
The prescribing cascade occurs when a side effect of a medication is misinterpreted as a new medical condition, leading to the prescription of additional medicines that may be unnecessary and potentially harmful. In patients with dementia, this can be common due to...