Polypharmacy
QUESTION
Look for certain groups of medications that have the potential for adverse outcomes. Example: Pain meds, Psychotropics, Beta Blockers, Antidepressants, Vitamins, Supplements, Diuretics, etc. Possible Points: 20
REVIEW: Look for possible drug to drug interactions, drug-disease interactions, drug-body interactions, and impact on functional status. Possible Points: 20
MINIMIZE: Nonessential medications. Which medications in the list clearly lack evidence for their use? Which medications have risks that outweigh the benefits and have a higher negative impact on primary functions (weight, pain, mood, vision, hearing, bladder, bowel, skin, swallowing, activity level, etc.? Possible Points: 20
OPTIMIZE: Address any duplication of medications or redundancy, discuss renal-cleared medications, medications that are metabolized by the liver, oral hypoglycemic in accordance to target HbA1c. Gradual dose reduction for antidepressants, beta blockers for physiological heart rate response or pacemakers, anticoagulants for INR guidelines, narrow therapeutic index medications such as Dilantin, etc. Possible Points: 20
REASSESS: Reassess heart rate, blood pressure, orthostatic, oxygen saturation at rest and activity. Reassess functional status, ADLs, and IADLs, cognitive status, medication compliance, etc. Points possible: 20
Sample Solutions
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