Comments on: Older Americans Use Risky Drug Combinations http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/ News, Comment and Conversation Tue, 16 Mar 2010 14:30:49 +0000 http://wordpress.org/?v=2.6.2 By: Mourning The Living http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/#comment-385978 Mourning The Living Wed, 31 Dec 2008 06:00:39 +0000 http://www.pharmalot.com/?p=18935#comment-385978 Her doctor has never suggested Plavix. I am afraid to suggest a change now. Every drug they gave her took something away. Nothing but time and hard work gave anything back. She is still on Aggrenox but no longer on Coumadin. I forgot to mention Dopamine and a few other things which will not come to me, that also didn't work to relieve the violent movement. Wish I had taped and YouTubed it if what insider says is true. Anyone taking something that could cause the same reaction would stop medicating after ten minutes with mom at her worst. The CNAs would scowl at her like she hit them on purpose even though she had no control of her arm. It takes a special kind of personality to do that job but that is another story. And you sadly wonder does the nurse treat your old man the way she should. She made you tea, asked for your autograph what a laugh. [Jethro Tull] Her doctor has never suggested Plavix. I am afraid to suggest a change now. Every drug they gave her took something away. Nothing but time and hard work gave anything back. She is still on Aggrenox but no longer on Coumadin. I forgot to mention Dopamine and a few other things which will not come to me, that also didn’t work to relieve the violent movement.
Wish I had taped and YouTubed it if what insider says is true. Anyone taking something that could cause the same reaction would stop medicating after ten minutes with mom at her worst. The CNAs would scowl at her like she hit them on purpose even though she had no control of her arm. It takes a special kind of personality to do that job but that is another story.

And you sadly wonder
does the nurse treat your old man
the way she should.
She made you tea,
asked for your autograph
what a laugh.
[Jethro Tull]

]]> By: Garry RX http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/#comment-385957 Garry RX Tue, 30 Dec 2008 21:03:57 +0000 http://www.pharmalot.com/?p=18935#comment-385957 As always we have the scenario of a patient being place on medications which cause harmful interactions and someone saying, its OK because someone will follow them. HELLO !!! Who is this someone. Dr. are hard to reach and don't respond in a timely fashion to calls from nursing homes or to patients. Where does the patient or family turn to. HELLO AGAIN... it is quite often the pharmacist who is asked to sort out the problem or to " suggest" alternatives. In a lot of cases the community pharmacist is not compensated for time spent reviewing inappropriate therapy and trying to put together an case to convince the physician their are potential problems. Most institutions will not allow documentation on the chart such as ' Physician advise of harmful side effects or drug interactions' This is an open invitation to the legal profession to take action. It seems this is the only way to establish a deterent to bad practice. As always we have the scenario of a patient being place on medications which cause harmful interactions and someone saying, its OK because someone will follow them. HELLO !!! Who is this someone. Dr. are hard to reach and don’t respond in a timely fashion to calls from nursing homes or to patients. Where does the patient or family turn to. HELLO AGAIN… it is quite often the pharmacist who is asked to sort out the problem or to ” suggest” alternatives. In a lot of cases the community pharmacist is not compensated for time spent reviewing inappropriate therapy and trying to put together an case to convince the physician their are potential problems. Most institutions will not allow documentation on the chart such as ‘ Physician advise of harmful side effects or drug interactions’ This is an open invitation to the legal profession to take action. It seems this is the only way to establish a deterent to bad practice.

]]> By: cdrillin http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/#comment-385790 cdrillin Sat, 27 Dec 2008 20:12:04 +0000 http://www.pharmalot.com/?p=18935#comment-385790 mourning- has your mother's physician considered plavix instead of the aggrenox? mourning- has your mother’s physician considered plavix instead of the aggrenox?

]]> By: Van http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/#comment-385677 Van Fri, 26 Dec 2008 03:50:14 +0000 http://www.pharmalot.com/?p=18935#comment-385677 I'm going to go out on a limb here, this isn't just older individuals. In a number of cases people will get away with something once but be unaware of the dangers so they continue on.... I know plenty of people in the range of 25 to 40 that take dangerous combos of drugs / substances. Simply because they are ignorant of what can happen. Drinking and meds, aspirin with other meds... This is nothing new. Is it a problem, yes, but it's nothing new. V http://vansantos.com I’m going to go out on a limb here, this isn’t just older individuals. In a number of cases people will get away with something once but be unaware of the dangers so they continue on….

I know plenty of people in the range of 25 to 40 that take dangerous combos of drugs / substances. Simply because they are ignorant of what can happen.

Drinking and meds, aspirin with other meds… This is nothing new. Is it a problem, yes, but it’s nothing new.

V

http://vansantos.com

]]> By: pharmavet http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/#comment-385658 pharmavet Thu, 25 Dec 2008 19:15:13 +0000 http://www.pharmalot.com/?p=18935#comment-385658 I would guess that if you asked most physicians to name one drug metabolized by cytochrome p 4503A4 or 2D6, they would give you a blank stare. Most of the older ones went to medical school before the drug metabolizing phenotypes were worked out. For these doctors, I would respectfully suggest a refresher course in clinical pharmacology, learning the drugs commonly used by the various metabolic pathways and how they are influenced by age. This is easier than trying to memorize drug labels. This might help to reduce drug interactions. I'm pretty sure there are CME courses in this area. I would guess that if you asked most physicians to name one drug metabolized by cytochrome p 4503A4 or 2D6, they would give you a blank stare. Most of the older ones went to medical school before the drug metabolizing phenotypes were worked out. For these doctors, I would respectfully suggest a refresher course in clinical pharmacology, learning the drugs commonly used by the various metabolic pathways and how they are influenced by age. This is easier than trying to memorize drug labels. This might help to reduce drug interactions. I’m pretty sure there are CME courses in this area.

]]> By: Insider http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/#comment-385640 Insider Thu, 25 Dec 2008 14:27:36 +0000 http://www.pharmalot.com/?p=18935#comment-385640 I'm sorry mourning. I think you've done a valuable service by describing this. Unfortunately the consequences of the bleed you describe is also a side effect of certain neuropsych drugs (not due to bleeds) and I fear we will be seeing much more of it in the future. Insider I’m sorry mourning.

I think you’ve done a valuable service by describing this.

Unfortunately the consequences of the bleed you describe is also a side effect of certain neuropsych drugs (not due to bleeds) and I fear we will be seeing much more of it in the future.

Insider

]]> By: Mourning The Living http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/#comment-385631 Mourning The Living Thu, 25 Dec 2008 11:44:44 +0000 http://www.pharmalot.com/?p=18935#comment-385631 Warfarin or Coumadin with Aggrenox If you think a stroke from a blockage is bad, try a bleed in the basal ganglia region (is it?). Loss of limb control to the extent of severe flailing. It is the most horrible thing I have ever witnesses and I saw it daily, for months, in my mother. Beating herself bloody broken and bruised. Shunned in a nursing home by other residents because she was knocking everything over and was considered to be too disruptive. Disliked by the CNAs because it was horrifying and exhausting to deal with. Frustrated and exhausted and crying and completely aware. Unable to participate in physical therapy to relearn to walk because she had no control of one leg or one hand needed to grasp a walker. It's been nothing short of heartbreaking. I fed her all of her meals until she learned to pin down one leg by crossing the other over top of it. She finally learned to pin down one arm with the elbow of the other so she could attmpt to hold a sippie cup. On holding down the offending limbs the movement shifted to her hip and side. Trust me when I tell you that there is no benefit to living life in that condition. I don't say that lightly. She is my best friend. When it came down to being responsible for her medical decisions I cried for days after signing her DNR. Fought to allow her a mind by refusing Haldol when it started almost immediately to harm her hearing and speech. Requip did nothing and it was a rediculous attempt. She was finally given Valium so that she could get some rest until they gave it to her so often that she was doing nothing but sleeping. I had them stop that and worked with her until she can now get by with the help of constant care. That is one drug combination that should be made illegal. Warfarin or Coumadin with Aggrenox

If you think a stroke from a blockage is bad, try a bleed in the basal ganglia region (is it?). Loss of limb control to the extent of severe flailing. It is the most horrible thing I have ever witnesses and I saw it daily, for months, in my mother. Beating herself bloody broken and bruised. Shunned in a nursing home by other residents because she was knocking everything over and was considered to be too disruptive. Disliked by the CNAs because it was horrifying and exhausting to deal with. Frustrated and exhausted and crying and completely aware. Unable to participate in physical therapy to relearn to walk because she had no control of one leg or one hand needed to grasp a walker. It’s been nothing short of heartbreaking. I fed her all of her meals until she learned to pin down one leg by crossing the other over top of it. She finally learned to pin down one arm with the elbow of the other so she could attmpt to hold a sippie cup. On holding down the offending limbs the movement shifted to her hip and side.
Trust me when I tell you that there is no benefit to living life in that condition. I don’t say that lightly. She is my best friend. When it came down to being responsible for her medical decisions I cried for days after signing her DNR. Fought to allow her a mind by refusing Haldol when it started almost immediately to harm her hearing and speech. Requip did nothing and it was a rediculous attempt. She was finally given Valium so that she could get some rest until they gave it to her so often that she was doing nothing but sleeping. I had them stop that and worked with her until she can now get by with the help of constant care. That is one drug combination that should be made illegal.

]]> By: Mike M http://www.pharmalot.com/2008/12/older-americans-use-risky-drug-combinations/#comment-385609 Mike M Thu, 25 Dec 2008 04:37:02 +0000 http://www.pharmalot.com/?p=18935#comment-385609 Thank you Ed, for following the horrible (but necessary) piece on a criminal pharmacist, with this example illustrating the profession's contribution to the advancement of knowledge and the public's health! Thank you Ed, for following the horrible (but necessary) piece on a criminal pharmacist, with this example illustrating the profession’s contribution to the advancement of knowledge and the public’s health!

]]>