Polluted polymedication

   Rampancy regarding polymedication or polypharmacy, in the practice of medicine is taking its toll fast and steadily. The insidious aftermath of overburdened prescriptions resulting out of forced target driven approach on the part of physician under stress, is adding to iatrogenic adversity all around the world.

For instance,the proton pump inhibitors (PPIs – medication reducing acid in stomach),one of the most prescribed drugs which almost every wise prescription has in its armour and which are used extensively to combat increased gastric acidity pouring out of ill effects of other medications( for example, NSAIDS) in the prescription besides their usual indications in GERD and peptic ulcer complications, are giving people, especially in the polymedicated elderly, more dementia and cognitive decline besides many other pitfalls in their action.

Do we really need such out of proportion prescription of PPIs which have a rather safe profile as such but the poor practice of polypharmacy has easily brought out  their true pernicious colors when undergoing drug-drug interactions in an overloaded prescription therefore polluting the highest level of our existence in the process. Well, a simple and safe drug prescribed to give comfort to our stomach has polluted our highest faculties of brain and mind. (https://doi.org/10.1155/2018/5257285). And what a pity we could not rectify the mistake.

Moreover, the story doesn’t end here as we have evidences against the aforesaid detrimental effects of PPIs reflecting the irony of empiricism in medicine. (https://www.medpagetoday.com/gastroenterology/gerd/71154)

Should I add a few other well established side-effects of PPIs(the arrhythmogenic hypomagnesemia and the seizural hypocalcemia in addition to the aforesaid untoward outcomes or should I stop here? Frankly speaking, I really don’t know, but my clarion conscience always guides me to explore other treatment opportunities and right mode of interventions in dealing with a case, for instance as here is the case with acidity.

What to do in such a dubious atmosphere? Should we add this drug or should we not in our prescription? Well, the confusion prevails and the humanity suffers. Conditioned reflex prescription writing out of this helplessness is widespread today,whether justified or not.

There are many examples like the PPIs, the list is endless. Among other culprits, NSAIDs, COX-2 inhibitors are the leading ones.

The herd instinct is dominant in medical fraternity and almost everybody is doing the same. Pressure of short term targets is leading to overloaded prescriptions without having a judicious ability of deprescribing the unnecessary medication during a follow-up. Do they fear a fall in the image of their proficiency by curbing down the already overloaded prescription or do they lack confidence originating out of paradoxical medical studies. Perhaps they will deprescribe when their patient has one foot in the grave.

This deadpan attitude of over-prescribing has to be dealt firmly and fast. The degree of awareness in treating a patient should exactly match with the degree of vision for keeping him safe. The idea of prescription should be in tandem with the conviction of deprescription.The doors to other treatment opportunities  with an aid of collective intelligence should always be open with a complementary hand.

Following here is a list of tools and insights by Tracemydoctor which would help equally the doctor and patient to counteract polymedication.

  • The physicians should implement effective medication management practices. They should follow a deprescription algorithm after reviewing the previous prescriptions during a follow-up.
  • They should keep all the records of medication intact and could ask for a helping hand from their learned pharmacists.
  • A hard work is needed in cases of old patients where they should follow The Beers List from the American Geriatric Society. (https://bit.ly/2GQhM2Y)
  • The Anticholinergic Burden Calculator warns against possible serious incoming hazards. It should be consulted without any biases.(http://anticholinergicscales.es/calculate)
  • Tracemydoctor humbly requests their cherished clients to be aware of side effects of their OTC drug adventures and dietary supplement speculations to avoid hot potato. Kindly visit https://examine.com before diving into the ambiguous world of supplements.
  • Explore other treatment modalities with expert’s advice in the respective field, as  for example, here in case of acidity, one may explore the possibility of usage of Natrum Phosphoricum biochemic salt of homoeopathy in place of PPIs along with other mainline conventional medicines in the prescription to combat acidity.

With vigilance on the part of physicians and awareness on the part of patients, one can easily avoid the shortcomings incorporated in our advance medical systems with respect to polymedication and polypharmacy.

Tracemydoctor(https://tracemydoctor.online) is here to fight against polluted polymedication.

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Blue Lotus

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