An Atypical Case of Extreme Polypharmacy

Abstract

A commonly reported definition of polypharmacy is the numerical definition of 5 or more medications daily, and definitions have ranged from 2 or more to 11 or more medications. In this case report, an extreme case of polypharmacy is presented, highlighted by the inordinate number of drugs used over time throughout the patient’s care. A 48-year-old African American female with multiple comorbidities experienced a serious adverse drug event (ADE) prompting reporting to MedWatch, the US Food and Drug Administration’s adverse drug event reporting system. The patient’s concomitant medications included 146 drug entities, across 82 therapeutic drug categories. It is apparent that the greatest influence on the occurrence of polypharmacy was the presence of multiple comorbidities, and treatment centered around addressing each morbidity with drug therapy. This case illustrates the insidious nature of polypharmacy and raises questions as to the appropriate progression and limits on the use of multiple medications.

Prevalence of hypertension and obesity in patients with type 2 Diabetes Mellitus

“…This can be explained by the fact that women are more concerned with their own health, thus increasing the number of women diagnosed with diabetes in relation to men (Schlichthorst et al, 2016;Silva, Araújo, Campos, 2018). Regarding the use of medications, about 87.5% of the participants used less than 5 medications and 12.5% used more than 5 medications (Table I), which in this case characterizes a polypharmacy (Veronin, 2022). In the study by Lima et al (2015), most diabetic patients used less than five medications, with an average of 4.6 medications.…”

Reconsideration of the current models of estimated kidney function‐based drug dose adjustment in older adults: The role of biological age

“…This is especially true because older adults are often on multiple medications (polypharmacy) and at risk for drug–drug interactions and adverse drug events even with dose adjustments 8 . According to current estimates, older adults commonly use five or more medications, several of which often require adjustment for kidney function 9,10 . Attention to this specific population has increased in the past few years with a focus on approaches to slowing the aging process.…”

“…8 According to current estimates, older adults commonly use five or more medications, several of which often require adjustment for kidney function. 9,10 Attention to this specific population has increased in the past few years with a focus on approaches to slowing the aging process. Postponing these age-related physiologic changes at the upper end of the lifespan can have pharmacokinetic (PK) consequences that also need further studies.…”