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Pharmaceutical Poisoning: Potential Scenarios

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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Drug toxicity: Drug–Drug Interaction01:30

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Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
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Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
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Drug Therapy01:28

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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[Polypharmacy, the new epidemic].

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    Polypharmacy, the use of multiple medications, increases patient risks. A systematic drug review and shared decision-making can improve medication management and patient outcomes.

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    Area of Science:

    • Gerontology
    • Clinical Pharmacy
    • Health Services Research

    Context:

    • Polypharmacy is a growing concern in multimorbid patients, leading to increased morbidity, mortality, hospitalizations, and healthcare costs.
    • Managing multiple medications in elderly and complex patients presents significant challenges.

    Purpose:

    • To outline a systematic approach for critically appraising each medication in patients with polypharmacy.
    • To emphasize the importance of patient preferences and shared decision-making in creating a clear medication plan.

    Summary:

    • A systematic drug review involves appraising indications, side effects, dosages, and alternatives for every medication.
    • Incorporating patient priorities and treatment goals is crucial for effective medication management.
    • Tools and strategies are presented to aid clinicians in this process, including empathic communication and interprofessional collaboration.

    Impact:

    • Implementing systematic medication reviews can reduce adverse events and healthcare utilization associated with polypharmacy.
    • Improved medication management through shared decision-making can enhance patient safety and quality of care.
    • Addressing challenges like time constraints and integrating technology are key to successful polypharmacy interventions.