Cardiology

Some drugs could be deprescribed and alternatives available

 

pexels-photo-140123.jpegWhen you think you might be taking too many medications

Discuss with your prescribing physicians and consult with your health care providers if you are taking more than ten medications.

  1. Evidence lacks that Docusate does what it claims to do: soften stools and help constipation. Replacement psyllium is more effective in most of the clinical trials in terms of relieving subjective constipation symptoms and several objective measures of constipation such as stool water contents, volume and frequency.
  2. Statins for the preventive purpose in people older than 75, the beneficial evidence is not clear or doesn’t out weight the side effects: muscle pain, interaction with other medications and toxicity.
  3. Benzodiazepine in elderly will increase the risk of fall, especially the Z’s – zolpidem, zelaplon and eszopiclone, particularly in the elderly who takes SSRI with a side effect of insomnia.
  4. Beta-blocker is good for reducing oxygen consumption for heart attack patients, but evidence lacks for three years after the cardiac infarction, especially if it is for the combined benefit of lowering blood pressure, because the effect of lowering bp is minimal.
  5. In general practice, many of the air way obstruction conditions (asthma, COPD) are being mis-diagnosed because of the lack of lung function test. These medications can be weaned off. Integrative medicine can be of advantages compared to beta-2 agonist and steroids.
  6. Muscle relaxant for back pain. These drugs have major side effects especially the toxicity when combining with alcohol,  compared to integrative medical approaches.
  7. A large body of evidence suggest that PPI is associated with increased cardiovascular risk and even early death. Other approaches and procedures should be considered and evaluated.
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