Polypharmacy Flashcards
(8 cards)
What is a prescribing cascade?
A prescribing cascade occurs when a medication causes side effects that lead to the prescription of additional medications, potentially resulting in inappropriate polypharmacy.
What is an example of a prescribing cascade?
NSAID use can lead to fluid retention, increasing blood pressure, which may result in the prescription of a calcium channel blocker (CCB), potentially causing ankle swelling. This can lead to diuretic use, concentrating uric acid and potentially developing gout.
Example of a prescribing cascade involving NSAIDs, CCBs, and diuretics.
What are key strategies for managing polypharmacy?
Regular medication reviews and agreeing on changes with the patient are essential. This includes stopping non-indicated drugs and prescribing new drugs only with clear indications.
Why is polypharmacy increasing?
Polypharmacy is increasing due to guidelines, hospital admissions leading to more medications, and an aging population.
What are reasons for inappropriate prescribing?
Reasons include over-enthusiasm, failure to recognize adverse effects, patient demands, failure to individualize treatment, and inadequate review.
What risks are associated with inappropriate prescribing?
Inappropriate prescribing can undo the benefits of medicines if they are prescribed excessively, in unsafe combinations, without patient consent, or without appropriate support.
What are the healthcare costs associated with multiple medicines?
Healthcare costs arise from adverse drug events, hospital admissions, and non-adherence.
What constitutes overprescribing?
Overprescribing occurs when patients receive medications they do not want, when potential harm outweighs benefits, when better alternatives are available but not prescribed, or when medications are no longer appropriate.
