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What do you call a prescription avalanche?

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jfgw
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What do you call a prescription avalanche?

#499148

Postby jfgw » May 7th, 2022, 7:53 pm

Is there a name for this?

A drug gets prescribed. It produces side-effects.
Another drug gets prescribed to counter the side-effects of the first drug. This produces its own side-effects.
Another drug gets prescribed to counter the side-effects of the second drug. This produces more side-effects.
And so on...


Julian F. G. W.

pochisoldi
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Re: What do you call a prescription avalanche?

#499152

Postby pochisoldi » May 7th, 2022, 8:26 pm

jfgw wrote:Is there a name for this?

A drug gets prescribed. It produces side-effects.
Another drug gets prescribed to counter the side-effects of the first drug. This produces its own side-effects.
Another drug gets prescribed to counter the side-effects of the second drug. This produces more side-effects.
And so on...


Julian F. G. W.


It's called "leaving your health to the professionals". When a patient gets to the second or third drug prescribed to counteract side-effects, they should tell the prescriber "hey, this is bonkers, lets start again from the top".

Sometimes you have to explicitly tell an expert "Hey, I appreciate the pressure you are under, but lets take a step back and look at the bigger picture", especially when they are on a "10 minutes per appointment" timetable.

UncleEbenezer
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Re: What do you call a prescription avalanche?

#499181

Postby UncleEbenezer » May 8th, 2022, 2:54 am


GrahamPlatt
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Re: What do you call a prescription avalanche?

#499183

Postby GrahamPlatt » May 8th, 2022, 5:11 am

Prescripchain?

AsleepInYorkshire
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Re: What do you call a prescription avalanche?

#499193

Postby AsleepInYorkshire » May 8th, 2022, 7:44 am

jfgw wrote:Is there a name for this?

A drug gets prescribed. It produces side-effects.
Another drug gets prescribed to counter the side-effects of the first drug. This produces its own side-effects.
Another drug gets prescribed to counter the side-effects of the second drug. This produces more side-effects.
And so on...


Julian F. G. W.

Is it a cascade event?

AiY(D)

didds
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Re: What do you call a prescription avalanche?

#499267

Postby didds » May 8th, 2022, 12:33 pm

jfgw wrote:Is there a name for this?

A drug gets prescribed. It produces side-effects.
Another drug gets prescribed to counter the side-effects of the first drug. This produces its own side-effects.
Another drug gets prescribed to counter the side-effects of the second drug. This produces more side-effects.
And so on...


Julian F. G. W.



It's whatever the term is for World Rugby's law changes since 1992

NotSure
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Re: What do you call a prescription avalanche?

#499289

Postby NotSure » May 8th, 2022, 2:57 pm

jfgw wrote:Is there a name for this?

A drug gets prescribed. It produces side-effects.
Another drug gets prescribed to counter the side-effects of the first drug. This produces its own side-effects.
Another drug gets prescribed to counter the side-effects of the second drug. This produces more side-effects.
And so on...


Julian F. G. W.


"Medicinal compound" interest?

(Let's drink a drink a drink......... And probably stop breaking the DAK rules.....)

rhialto
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Re: What do you call a prescription avalanche?

#500208

Postby rhialto » May 13th, 2022, 9:56 am

Use of multiple medications inadvertently introduced by a physician -> Iatrogenic Polypharmacy

stewamax
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Re: What do you call a prescription avalanche?

#500239

Postby stewamax » May 13th, 2022, 11:50 am

It is not just what the side-effects of the second or third drug on their own are, but what are the effects of the second drug interacting with the first, the third interacting with second, the third interacting with first AND … the second plus third COMBINATION interacting with the first, etc.

The second could perhaps, be a catalyst to kick the third to produce an intermediate chemical that in turn modified the action of the first, or the combination could be an adjuvant for the action of the first.
Now add a fourth, and the possible interactions become unpredictable and unmanageable.

The underlying issue was nailed down mathematically in a different sphere by the late architect Chris Alexander*, and it is one of the corner-stones of object-oriented IT systems design where uncontrolled interactions between pieces of code must be minimised (or in architecture, unwanted interactions between elements of a building)


* vide his “Notes on the Synthesis of Form”

redsturgeon
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Re: What do you call a prescription avalanche?

#500281

Postby redsturgeon » May 13th, 2022, 3:23 pm

One of the most important jobs that a pharmacist can do (and they are paid for doing it each time) is a "Medicines Use Review". The pharmacist will sit down with the patient and take a look at all of their medication to understand what is being prescribed and why. Most times Mrs RS has done these she had sent a note to the GP to review at least one medication and either remove or adjust dosage.

There are many combinations though that are deliberate and useful, eg. anti nausea drugs given with medicines likely to cause nausea or drugs given to protect the gut against the damaging effects of some anti inflammatories.

John


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