The Art of Safe and Judicious Deprescribing in an Elderly Patient: A Case Report

Gareri, Pietro; Gallelli, Luca; Cotroneo, Antonino Maria; Manfredi, Valeria Graziella Laura; Sarro, Giovambattista De

doi:10.3390/geriatrics5030057

Cited by 4 publications

(4 citation statements)

References 25 publications

(28 reference statements)

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“…Gareri et al report the case of an 81-year-old man with a clinical history of diabetes, blood hypertension, non-valvular atrial fibrillation, chronic obstructive pulmonary disease, osteoarthritis, anxiety, and depression. 17 The patient was taking 11 different drugs daily. The authors conclude that prudent deprescribing in older adults is needed and avoiding potentially inappropriate drugs.…”

Section: Discussionmentioning

confidence: 99%

An Atypical Case of Extreme Polypharmacy

Veronin

2022

DHPS

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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.

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Section: Discussionmentioning

confidence: 99%

An Atypical Case of Extreme Polypharmacy

Veronin

2022

DHPS

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“…We need to implement safe and judicious deprescribing, especially in older aged patients where polypharmacy is prevalent. 15 Moreover, in Sweden, medications are graded on their environmental effects, and clinicians are required to prescribe a less environmentally damaging drug where the option exists. 16,17 It is worth considering generalizability of such initiative to apply to other populations.…”

Section: The Way Forward: What Can Be Donementioning

confidence: 99%

What healthcare leadership can do in a climate crisis

Sergeant

Hategan

2023

Healthc Manage Forum

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Healthcare governing boards, executives, medical staff, health professionals, and allied staff members should all play a role in devising, promoting, and implementing solutions for climate change mitigation, which must extend beyond the boundaries of their own workplaces and healthcare institutions. Such actions can potentially influence not only healthcare professionals and their patients but also healthcare supply chains and entire communities. Thus, leaders of healthcare organizations can play a vital role in leading by example. The authors herein propose some initiatives for promoting and implementing a culture of sustainability and climate action in medicine.

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“…Neuroprotective, neuromodulatory, effect on phospholipid synthesis, decrease of their peroxidation, increase of blood flow, cerebral oedema reduction, increase of superoxide-dismutase activity, enhancement of acetylcholine, dopamine and noradrenalin synaptic levels, activation of SIRT-1 and neuronal repair [38][39][40].…”

Section: Citicolinementioning

confidence: 99%

“…Increased levels of acetylcholine [38,39]. Increased levels of dopamine, noradrenaline and serotonin; this generates interference with drugs acting on these pathways [38,39].…”

Section: Vitamin Cmentioning

confidence: 99%

Nutraceuticals for Peripheral Vestibular Pathology: Properties, Usefulness, Future Perspectives and Medico-Legal Aspects

Chiarella

Marcianò²,

Viola

et al. 2021

Nutrients

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Vestibular disorders may generate complex signs and symptoms, which may alter patients’ balance and the quality of life. Dizziness and vertigo can strongly affect daily activities and relations. Despite the presence of conventional drugs, maneuvers, and surgery, another interesting therapeutic opportunity is offered by nutraceuticals. These molecules are often used in the treatment of dizziness and vertigo, but the rationale of their application is not always solidly demonstrated by the scientific evidence. Several substances have shown a variable level of efficacy/usefulness in this field, but there is lack of important evidence for most of them. From a medico-legal point of view, specific information must be provided to the patient regarding the efficacy and possibilities that the use of these preparations can allow. Administering the right nutraceutical to the proper patient is a fundamental clinical skill. Integrating conventional drug treatment with nutraceutical administration seems to be easy, but it may be difficult considering the (in part unexplored) pharmacodynamics and pharmacokinetics of nutraceuticals. The aim of the scientific community should be to elevate nutraceuticals to the same law and technical dignity of conventional drugs.

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The Art of Safe and Judicious Deprescribing in an Elderly Patient: A Case Report

Cited by 4 publications

References 25 publications

An Atypical Case of Extreme Polypharmacy

An Atypical Case of Extreme Polypharmacy

What healthcare leadership can do in a climate crisis

Nutraceuticals for Peripheral Vestibular Pathology: Properties, Usefulness, Future Perspectives and Medico-Legal Aspects

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