Polypharmacy and drug interactions

#KYJ - Polypharmacy
www.ect4health.com.au/rustypills/
Interesting term, but one we need to know more about.   Polypharmacy is defined as 4 or more concurrent medications.  The issue is drug to drug interactions that occur when a person takes two or more drugs that are metabolised by the same enzyme systems in the liver and other tissues.
Many medications use a system called Cytochrome 450 enzymes(P450).
If drug A and drug B are both metabolised at the P450, then metabolism of both drugs can be impaired or delayed, rendering both inactive or toxic.  These interaction can make one or both medicines overly potent.

The issue compounds with every extra medication a person takes. In fact if your patient takes 5 medications, there is a 50-80% chance of an adverse effect.  What's worse, is that the risk increases 12-15% for each extra drug in that little dosette box.

Take Lipitor (Atorvastatin) the worlds most prescribed drug.  It has over 250 drugs that interact with it to cause adverse effects.
Common medications  causing issues in combination with Lipitor include:
amlodipine
aspirin
atenolol
Cymbalta (duloxetine)
Fish Oil
gabapentin
hydrochlorothiazide (Enduron)
Lasix (frusemide)
levothyroxine
lisinopril
metformin
metoprolol
Nexium & omeprazole
Plavix (clopidogrel)
Synthroid (levothyroxine)
Vitamin D3 (cholecalciferol)

These drugs are hard to get our head around, but the issue of polypharmacy being linked to dementia, falls and muscle atrophy in elderly is one that is on the rise, and needs clinicians to be wary and hyper vigilant.

Our latest Rusty Pills seminar discusses this issue and many others.
Check out http://www.ect4health.com.au/rustypills/