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Polypharmacy In The Elderly
by Trino Medina, RPh
Doctors Renaissance Hospital Clinical Pharmacist, CVS Clinical Pharmacist
published July 2017

I took my mom to her cardiologist today and he gave her a clean bill of health! I was so happy to hear him say how healthy this 88 year woman and that her heart was strong.

I brought up my concern to him about my mom taking too many medications. She takes pills for her heart, her diabetes, and her pain. Can we reduce the amount of pills she takes each day?

Polypharmacy is the practice of prescribing many different medications for the same condition to the same patient. My mom has consistently been a subject of this practice. I have vowed to help her and the many patients out there to try and reduce the amount of pills they take. Starting with the heart pills, my mom takes an aspirin a day to help reduce blood clotting. This one we were not able to remove. She also takes diltiazem, metoprolol and isosorbide for her heart. Working with the cardiologist we were able to remove the diltiazem and the isosorbide only leaving the metoprolol.

She takes celecoxib, tramadol and acetaminophen for pain and inflammation. Talking with the pain doctor, we removed the celexocib and replaced it with diclofenac. We then added gabapentin to replace the tramadol. Tramadol makes my mom too groggy and susceptible to falls.

We decided to leave the acetaminophen arthritis for now until further evaluation. We have yet to visit the endocrinologist on her diabetes medications, but I have a good feeling we can cut down on one of those two.

As you can see, polypharmacy happens because the primary physician sends out his patients to the different specialists who then prescribe different medications for their area of expertise. Each one is cognizant of all the meds but don't alter treatment for another ailment.

It is up to the patient or family member working closely with the primary physician to try to evaluate each ailment and share with the specialist where the patient is at in the different illness.

I am in no way advocating anyone removing or altering any medication regimens on their own, but rather work with all of your doctors on a better way of treating your ailments, other than polypharmacy.