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Too Many Medications?

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Prostate Cancer
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Too Many Medications?  
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garyi
Veteran Member
Joined : Jun 2017
Posts : 1242
Posted 10/26/2018 1:34 PM (GMT -7)
Something to consider for all of us. From the University of Miami:

Medicines are a tricky thing.

They can be lifesaving — when used appropriately. Sometimes, they are prescribed when they shouldn’t be; they are not prescribed when they should be; or we don’t take them correctly. When patients are taking a multitude of medicines, it’s called polypharmacy. This may be dangerous because it is hard to predict how several medications are going to interact. That includes prescription drugs, over-the-counter medicines, and herbal supplements.

Polypharmacy is often defined as the consumption of five or more medicines, and/or supplements, on a daily basis. In one 2016 study, 100 patients, both men and women over age 65, were admitted to a hospital. More than half of the patients received five to nine different drugs. On admission, more than 52 percent of potential drug-drug interactions were observed.

Dr. Stephen Avallone, a physician with the University of Miami Health System, agrees that polypharmacy is a big problem, especially in the elderly. He urges patients to sit with their doctors and go over all the medications they are taking, including vitamins and herbal supplements.

“During an initial visit, we often reconcile medications with the health issues in a patient’s file,” he says. “Those medications and supplements that are not aligned with a particular condition are usually the first to be considered for removal from a person’s medical regimen.”

Too many medications can be harmful

Sleeping pills, anti-anxiety medications, and other medications may interfere with cognitive function and some combinations may put a patient at risk for injury. For instance, if you wake up groggy in the middle of the night after taking a sleep aid, you could trip and fall, leading to hip fracture requiring hip replacement, says Dr. Avallone.

Pharmacists have programs that alert them to potential interactions between two drugs. Unfortunately, it isn’t possible to accurately predict the side effects or clinical effects of a combination of drugs, because the effects also vary among individuals, due to each individual’s genetic make-up.

“Excessive supplement use can also interfere with prescribed medications in some cases,” adds the doctor. “In an effort to stay well, sometimes people can take too much of a certain supplement or vitamin and don’t realize that it may be harmful rather than helpful.”

For example, high doses of Vitamin C may cause kidney stones to develop.

If you do feel like you are having a reaction to a drug, call your doctor for advice,” says Dr. Avallone. “Some drugs are crucial to your health and some, when stopped, must be tapered off to prevent rebound side effects.

“Don’t just decide on your own to stop taking a drug. Talk it over with your doctor first and come up with a plan you can live with.”

Gary
72years old @ Dx, LUTS for 7 years
Ulcerative Colitis since 1973
TURP 2/16, G3+4 discovered,
3T MRI fusion guided biopsy 6/16
14 cores; G 3+3, one G3+4
RALP 7/17 G3+4 Organ confined, but...
<1mm positive margin on Epstein check
pT2c pNO pMn/a
98% dry, ED minimal
ercMRI & DCFPyL PET Scan @ NIH/NCI
1" tumor remains at apex. No mets.
Persistent PSA .54 after 4 months
2ADT; IMGT 70.2 GY, over 5/18
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PDL17
Veteran Member
Joined : Oct 2011
Posts : 590
Posted 10/26/2018 6:02 PM (GMT -7)
It is a huge problem. As a pharmacist I have noticed over the years that physicians are much more liberal regarding writing prescriptions. When I was a young pharmacist, physicians had fewer choices but were also more cautious regarding prescribing them. Multiple docs write multiple prescriptions on a patient and in my experience, it is common for a patient to be taking 20 or more medications. Patients need to constantly ask questions: 1. Do I really need all the medication I am taking? 2. Are all of my physicians aware of what I am taking? 3. Do any of these drugs interact with one another (most physicians will not know...I would recommend a pharmacy I trust and ask the pharmacist to review my list for interactions. It is important that everyone knows which supplements, vitamins or over the counter meds you are taking. 4. If you decide not to take a medication or can't afford it, you need to speak up. The physician assumes you are taking what he has prescribed and has assessed you based on that. It is not unusual for patients to not take certain medications such as for high blood pressure for various reasons. When they go back to their physician and their pressure is high, he/she will add another drug believing what they prescribed is not enough. More often than not, no one will ask you if you are indeed taking your medication.

Good topic and thanks for posting it.

Paul
Gleason 3+4; 5/16 positive cores; average volume 30%; PSA prior to tx 4.8
TX-IMRT + brachytherapy; IMRT Nov. 2011; Brachytherapy Feb. 2012
PSA April 2012--3.6
PSA May 2012--2.5
PSA Aug 2012--2.2
PSA Nov 2012--2.9
PSA Feb 2013--2.8
PSA May 2013--2.1
PSA Aug 2013--2.3
PSA Nov 2013--2.5
PSA May 2014--1.1
PSA Dec 2014--0.8
PSA Jun 2015--0.5
PSA Aug. 2016--0.4
PSA Mar. 2017--0.3
PSA Mar. 2018--0.15
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logoslidat
Veteran Member
Joined : Sep 2009
Posts : 6408
Posted 10/26/2018 6:22 PM (GMT -7)
Great topic....soon to be significant...hence...by...by...american pie...a whimper...smelt
gleason 9 contained stopped psa testing jan 2015 with two consecutive psa's a year apart at 0.15
surgery 10/09 only treatment...eyes wide open...no sand...gonna live til I die...not the reverse forgive my virtues as well as my sins...
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InTheShop
Elite Member
Joined : Jan 2012
Posts : 10355
Posted 10/26/2018 9:19 PM (GMT -7)
The problem gets worse when you are seeing many doctors - PCP, URO, oncologist, etc. It can be pain to keep reminding each doctor you see of what you're taking.
I'll be in the shop.
Age 58, 52 at DX
PSA:
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17, .3 10/17 .3 4/18
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
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MG0351
Regular Member
Joined : Jul 2018
Posts : 192
Posted 10/27/2018 7:29 AM (GMT -7)
I make a list of all meds on my phone.....
DX 7/23/18
Gleason 9
Prostate size 44
stage T2B
No mets.
PSA 5.2
6/16 probes positive 2 maybes.
All on right side 1 on the left
Age 65 with lung problems.
HT 8/22 Eligard 6 month shot
UROLIFT 10/24
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Bohemond
Veteran Member
Joined : Apr 2012
Posts : 1072
Posted 10/27/2018 12:26 PM (GMT -7)
My 93 year old mother still lives in the house I grew up in. My wife turns up every week for shopping, running the laundry etc. I turn up to do maintenance mow grass, clear snow, etc., and we call her every night to be sure she's ok.She has multiple health problems - heart, kidneys, diabetes but is mentally sharp and determined to stay in her own home as long as possible. Aside from stays at our house for holidays, etc. we take her in here from time to time after she's been hospitalized for one thing or another. Two years ago we moved her to our house for a few weeks because she was having recurring bouts of nausea and intermittent times when she was not her usual lucid self. She'd been to her own doctors and had had a brief stay in the hospital and was then sent home. She thinks her primary care doctor is wonderful. But even prior to this my wife and I concluded he was lazy and poorly informed -- I'm struggling to say politely what I really think.

Two days after taking her to our house she woke us up at 4 a.m. She was extremely nauseous and was also not very lucid. My wife and I were thinking stroke or heart attack. We had the ambulance take her to our local community hospital - which is not her own hospital. Over the next couple of days the hospital staff doctor reviewed all her meds adjusted doses and took her completely off at least one of them. She very quickly returned to her normal self - no more nausea and perfectly lucid. This even though she only weeks before been in her local hospital had follow-up appointments with her own doctors. Fortunately the staff doctor at our community hospital looked at her with no predetermined opinions about her medical conditions or treatment and what he saw was a needless jumble of medications.

Jim

Post Edited (Bohemond) : 10/27/2018 1:40:41 PM (GMT-6)

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Fairwind
Veteran Member
Joined : Jul 2010
Posts : 3947
Posted 10/27/2018 2:00 PM (GMT -7)
Everyone, but especially the elderly, (those over 65) need to be very careful about how many drugs they are taking and what those drugs are supposed to be doing...ALL drugs are chemicals that have some sort of side effects. When you start taking multiple drugs and supplements, these side effects can gang up on you, produce symptoms nobody can diagnose...Next thing you know, they are feeding you more drugs! In most cases, a small lifestyle or diet change can accomplish the same result as an expensive prescription drug..I have found exercise is the best drug of all...
Age now 75 . Diagnosed G-9 6/2010. RALP, Radiation failed
Lupron, Zytiga, PSA <0.1 10/16 no change <0.1 5/17 PSA 1.6 Chemo or Provenge next..Sept '17, PSA now 9.2. ADT including Zytiga has failed. Will investigate treatment options. 11/17 PET/CT clear, but 4 new bone mets..Going to try Xtandi and see how I respond to that..3/2018 PSA now 54, chemo next. 5?10/18, PSA 200, Dosetaxel started..
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Everton
Regular Member
Joined : Jun 2017
Posts : 145
Posted 10/27/2018 7:53 PM (GMT -7)
So true about the meds, I had a few sit downs with the pharmacist when I had my chemo and an operation I think I was up to 7 or 8 different prescriptions. I always stick to one pharmacy. I always take a written list of meds with me to doctor appointments.
Age 59 when DX
DX Nov 2016
PSA 350
Bone & Lung Mets
Lupron @ 90 days
Gleason 9 ( 5 + 4 )
Jan Chemo
2017 June .018 Sept .016 Dec .058
2018 March .320 June .81 Aug 2.6
Zytiga Started Sept
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InTheShop
Elite Member
Joined : Jan 2012
Posts : 10355
Posted 10/27/2018 10:00 PM (GMT -7)
I know a guy who was arrested for having too many medications...
I'll be in the shop.
Age 58, 52 at DX
PSA:
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17, .3 10/17 .3 4/18
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
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