Polypharmacy Flashcards
Why would you rather have a slightly high BP in the elderly than a low?
The risk of hypotension is a worse risk than the cardiovascular risk. They can cause falls which can kill quickly and may not be preventable outside of BP.
What is the target for apixiban?
Factor Xa in the bloodstream and on platelets, to prevent clotting. Often used in AF to prevent MI, strokes etc.
It can cause nausea,
What is the general guide for drugs that shouldn’t be stopped?
If it replaces something vital e.g. insulin
Drugs that cause rapid symptomatic decline or loss of disease control
Drugs with strong evidence for prevention
What is the general guide for drugs that can be stopped?
The reason no longer exists
The risk/benefit is appropriate
Medicine combinations are hazardous
When taking patients off medication, what is most important to consider?
The patient’s opinion.
The pros and cons in their perspective is often important to know which of the drugs you can remove, you should remove.
What are the main anti-cholinergic side effects? (in drugs like LAMA, mirtazapine, sertraline… so many yikes)
Head to toe
Drowsiness, dizziness, confusion and hallucinations
Blurred vision
Dry mouth
Constipation
Skin flushing, no sweating or overheating
Rapid heart rate
Urine retention
