Mrs. M is an 87-year-old female residing in a skilled nursing facility. Her medication list includes: Apixaban 5 mg BID (for atrial fibrillation) Docusate 100 mg BID Senna 8.6 mg BID PEG 17 g daily Calcium carbonate 500 mg TID Lisinopril 10 mg daily Metoprolol...
Benign prostatic hyperplasia (BPH) is one of those conditions that creeps up with age and quietly causes a whole bunch of problems—especially when medications make it worse. A patient might come in complaining of frequent urination, a weak stream, or feeling like they...
I think I’ve seen this scenario play out more times than I would like. A patient is prescribed both a laxative, Senna, and Questran (cholestyramine), a medication used to manage diarrhea symptoms. This example of the prescribing cascade often presents slowly...
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...
One of my biggest pet peeves is the use of sulfonylureas with insulin. Recall that sulfonylureas stimulate the release of insulin and in many patients with Type 2 diabetes we may not be getting much out of the sulfonylurea or in some cases, the extra boost in insulin...
