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Polypharmacy in a Patient With Intellectual and Developmental Disabilities
Rishi Raj1, Douglas Owen2, Lakshmi Kannan3
1Endocrinology, Diabetes and Metabolism, Pikeville Medical Center, Pikeville, USA.
Cureus
|March 14, 2022
Summary
Adults with Prader-Willi syndrome (PWS) face risks from multiple medications. Poor communication can lead to complications like acute kidney injury, emphasizing continuity of care for individuals with intellectual disabilities.
Area of Science:
- Internal Medicine
- Nephrology
- Genetics
- Pharmacology
Background:
- Prader-Willi syndrome (PWS) is a rare genetic disorder with adult manifestations including obesity, hypogonadism, osteoporosis, cardiovascular disease, diabetes, and sleep apnea.
- Individuals with PWS often have mild to moderate intellectual disability, necessitating caregiver involvement in healthcare.
- Polypharmacy is common in PWS patients, increasing the risk of adverse drug events and interactions.
Observation:
- A case report details a 26-year-old adult with PWS and intellectual disability who developed acute kidney injury.
- The acute kidney injury was attributed to an interaction between multiple nephrotoxic medications.
- This highlights potential communication gaps between healthcare providers and caregivers regarding medication management.
Findings:
- Drug interactions involving nephrotoxic agents can precipitate acute kidney injury in vulnerable PWS patients.
- Intellectual disability in PWS patients can exacerbate risks associated with polypharmacy.
- Effective communication and medication reconciliation are crucial for preventing adverse events.
Implications:
- Continuity of care with primary care providers is essential for managing complex health needs in PWS.
- Enhanced vigilance for drug interactions and nephrotoxicity is required in patients with PWS and intellectual/developmental disabilities (IDD).
- Improved interdisciplinary communication strategies are needed to ensure patient safety and optimize PWS management.
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