I got a degree in Clinical Psychopharmacology after getting my license to practice as a Doctor of Psychology because I started working w/older adults who struggled emotionally AND were prescribed a TON of meds. Something wasn’t right. I had to know more. @division_55 1/7
Not only did i learn basic clinical medicine, pathophysiology, review of systems, lab workups, etc.. but also learned about effects of drug-drug, drug-disease interactions on mood, mind, behaviors, and stress. One tool i still find useful is the #BeersCriteria (not etoh..lol) 2/7
Here’s a link to 2020 Updated from 2015 guidelines from @aafp aafp.org/afp/2020/0101/… Inappropriate Medication Use in Older Adults. If you have an older adult in your life, check their med-list. You’ll be surprised. Or maybe not. Here are “key points of practice”: 3/7
-Avoid most antipsychotics in patients w/Parkinson disease complicated by psychosis: use quetiapine, clozapine, pimavanserin with caution.
-Avoid using rivaroxaban and dabigatran because of ↗️ bleeding risk vs warfarin and other direct oral anticoagulants (alcohol too) 4/7
-Avoid using rivaroxaban and dabigatran because of ↗️ bleeding risk vs warfarin and other direct oral anticoagulants (alcohol too) 4/7
-Avoid tramadol use because of the risk of hyponatremia from syndrome of inappropriate antidiuretic hormone secretion.
-Avoid prescribing opioids with benzodiazepines or gabapentinoids because the combinations increase the risk of severe respiratory depression. (Alcohol too!) 5/7
-Avoid prescribing opioids with benzodiazepines or gabapentinoids because the combinations increase the risk of severe respiratory depression. (Alcohol too!) 5/7
pharmacytimes.com/publications/i…
Even when prescribed in appropriate doses, for the right conditions, medications can ↗️ risk for death.
Counterintuitive as may seem, decades of data demonstrate when patients take multiple meds for multiple conditions (#polypharmacy), odds of...6/7
Even when prescribed in appropriate doses, for the right conditions, medications can ↗️ risk for death.
Counterintuitive as may seem, decades of data demonstrate when patients take multiple meds for multiple conditions (#polypharmacy), odds of...6/7
...adverse efx, hospitalizations, even death are significantly ↗️. When meds are studied for efficacy/safety, they’re often studied in individuals taking few other meds and with few other chronic diseases. @DBenitezPsy @DrDeepChat007 #prescribingpsycholgists can help. #vtpoli 7/7
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