Polypharmacy is when a patient takes many drugs, both prescription and over-the-counter, and is more common in the elderly. It can lead to adverse reactions and pill loading, but may be necessary in some cases. Patients can reduce the risk by seeing a primary care physician and disclosing all medications used.
Polypharmacy or “many drugs” is a situation that occurs when a patient takes many drugs, both prescription and over-the-counter. This situation is more common in the elderly, as they often have complex medical conditions that require the use of numerous medications for proper management, but it can occur in people of any age. Doctors make a distinction between polypharmacy studied and unstudied, or thoughtless and thoughtful, to emphasize that sometimes polypharmacy occurs out of necessity and other times it can actually endanger the patient.
The more drugs someone takes, the more they are at risk for adverse reactions. If a patient receives all prescriptions from the same doctor and fills them at the same pharmacy, any concerns about drug interactions are usually addressed quickly. However, when a patient receives prescriptions from several physicians who may not communicate, or fills prescriptions at multiple locations, or purchases over-the-counter medications such as aspirin, herbal medicine, and so on and does not disclose, adverse drug reactions may occur, and may not be identified by a doctor.
Polypharmacy can also create a situation known as pill loading, where a patient has so many medications that they cannot manage them all properly. Pill burden can increase the risk of noncompliance, and the patient may also accidentally overdose, miss certain medications, or take medication at the wrong time as the pill burden becomes excessive.
In some patients, polypharmacy may be considered necessary. AIDS patients, for example, usually need to take many medications, and the use of each drug is evidence-based and entirely appropriate. On the other hand, a patient taking an eclectic assortment of medications which may include medications taken to address the side effects of other medications may be considered the victim of an unstudied polypharmacy, where a physician fails to fully assess the situation, or not having the necessary information to do so.
Patients can reduce the risk of polypharmacy by seeing a primary care physician and asking specialists to forward medical records and prescription information to the primary care physician. It’s also important to keep a list of all medications used, including prescriptions, over-the-counter medications, herbal regimens, and so on. Patients may feel shy about disclosing all of their medications, but this is vitally important, as failure to disclose medication use can result in serious complications or even death.
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