Lecture 7: Polypharmacy

Gerald is an 89 year old man with established dementia; he attends with worsening confusion, reported by his care home. They had been in touch with his GP earlier in the week, who suggested a course of antibiotics for a UTI, to which he is prone, however this has made no difference.

Gerald has a long history of depression, and in addition has heart failure, and well controlled epilepsy.

He takes the following medication:

  • Mirtazapine (60 mg od)

  • Furosemide (40 mg od)

  • Atenolol (50 mg od)

  • Captopril (50 mg bd)

  • Carbamazepine (200 mg od)

Q1: What further information do you need to undertake a medicines rationalisation?

Q2: Which drugs would you stop?

Q3: Which drugs would you start?

Videos

Pain Management: Prof. Simon Conroy & Dr Jay Banerjee discuss the appropriate pain relief for a frail older patient admitted to the Acute Frailty Unit (AFU).

MedStopper: a parody of The Beatles song, Day Tripper. Starting and stopping medications is like the bliss of marriage and the agony of divorce. That's the completely wrong concept!

Bohemian Polypharmacy: a parody of Queen's classic song Bohemian Rhapsody, all about Polypharmacy (taking more medicines than are clinically indicated).

Make It Easy: a parody of the great song by the Eagles, Take It Easy. The concepts of minimally disruptive medicine put to music!

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