Polypharmacy: More is Not Always Better
Polypharmacy is defined as the concurrent use of multiple medications, usually taking more than four, in order to manage several different illnesses or decrease chances of serious complications but results in negative outcomes. This includes prescribed drugs, the over-the-counter (OTC) drugs, herbal remedies and dietary supplements. The combined use of these drugs can interrupt desired drug-drug or drug-body interactions which results in adverse drug reactions (ADR). Polypharmacy is especially prevalent among patients over age 60 due to several different reasons. About 1 in 3 elderly patients take more than 8 different drugs each day, with many taking 15 or more (Lilley, Rainforth, Snyder, 2012, p. 42). Elderly patients are more prone to develop age-related illnesses concurrently due to aging of body and physiological changes. As a result, elderly patients are more susceptible to have frequent occurrence of chronic diseases than younger populations. Although prescribing multiple medications are appropriate, it is inevitable to avoid the increased risk of ADR. This creates even more dangerous situation where side effects are misapprehended as symptoms of a disease and requiring stronger or more doses of additional medications. Polypharmacy is associated with an increased risk of falls, drug interactions, drug disease interactions, and drug errors (Oboh, 2013). Therefore, it’s significant to focus on cause and effect of polypharmacy so that health care professionals can prevent any preventable complications and ADR.
The Aging Body and Physiological Changes
Aging is a naturally occurring process accompanied with some major physiological changes such as declined or loss of organs and functions. The aging of the body is mainly characterized by reduction in pharmacokinetic functions including absorption, distribution, metabolism and excretion. This not only leads to chronic diseases such as diabetes, kidney disease and heart disease but can have a profound effect on the way the body handles medications (Garner, 2013). The elderly patients simply have more to start compared to younger populations. More than 80% of patients taking eight or more drugs have one or more chronic illnesses (Lilley, 2012, p. 42). With as many as 44 percent of men and 57 percent of women over the age of 65 taking five or more medications per week (Iglarsh, 2012). While taking more than two drugs can increase the risk of an adverse effect, taking more than five drugs increases that risk by 16%, and as the number of drugs taken and the age of the person increases, so does the risk for adverse drug interactions (Nobili A, Pasina L, Tettamanti M, et al. 2009). As number of medicines increases so does the chances of having ADR or serious complications such as toxicity which lead to more harms than benefits.
Polycascade: Symptoms or ADRs?
There are some cases when specific medications may be given deliberately to induce the ADR of other...