Polypragmasy means unreasonable use of many drugs at the same time. Incorrectly used multi-drug therapy increases the risk of side effects that may threaten not only the he alth, but also the life of the patient. Polypragmasy is dangerous for everyone, but the most important for the elderly, who struggle with many diseases and therefore have to take many medications. Check what the effects of polypragmasy may be and which combinations of drugs are particularly dangerous.

Polypharmacyis the taking by the patient of many drugs simultaneously in an irrational way, i.e. in the wrong combination, dose or more than indicated, etc.

Irrational taking of several medications at the same time may lead to side effects, often dangerous to he alth or even life. The risk of side effects increases with the number of medications taken, and amounts to 5.6%. in the case of simultaneous intake of two drugs.

With 5 drugs the risk is 50%, while with 8 and more it increases to 100% .¹ Polypragmasy is dangerous for everyone, but especially for the elderly, because seniors are the main consumers of drugs. Research results in Poland show that more than half of the elderly patients use more than 5 drugs in their daily treatment regimen, and more often than every 10 - at least 10 drugs .¹

Polypharmacy should not be confused with another centuries-old therapy -polypharmacy- which consists in taking an appropriate combination of drugs, adapted to the patient's he alth condition and its comorbidities. It is rational, safe and effective use of several drugs at the same time.

Polypharmacy - reasons

Prescribing many drugs to a patient for simultaneous use requires the doctor to know the mechanisms of action of drugs, knowledge about changes in the concentration of the drug (or its metabolites) in the body, knowledge about the side effects it may cause, and with which drugs may interact.

Polypharmacy, polypharmacy, polypharmacy and polypharmacology are terms that are used interchangeably to describe a situation in which the patient takes more thanseveral drugs at the same time.

It is not easy, so it happens that a doctor prescribing multi-drug therapy may make a mistake (the so-called iatrogenic error), which may consist in the wrong selection or dose of the drug. He may also make a mistake by prescribing a drug without identifying the cause of the disease, using drugs with unconfirmed efficacy or deciding to continue treatment despite the occurrence of side effects.

Polypragmasy may also be the result of uncoordinated treatment of the patient by many doctors. Each doctor treats only what he or she knows, and does not see any other diseases.

The patient can also contribute to polypragmasy by taking medications not in accordance with the doctor's recommendations or taking over-the-counter medications, such as dietary supplements, which also interact with medications.

Worth knowing

In Poland, the record holder took over 300 medications

The record holder in taking many drugs is a 90-year-old resident of the Łódź Province. In the first five months of 2016, he bought over three hundred packages of various drugs. This is very dangerous, because the more drugs, the more difficult it is for the doctor to precisely monitor the treatment.

Polypragmasy - effects. What is the risk of unreasonably taking many drugs at the same time?

The most harmful thing is taking many drugs that interact with each other, i.e. they interact with each other, which results in a different effect on the body:

  • intensification or weakening of the effect of drugs
  • shortening or extending their operation time
  • emergence of a completely new action (including toxic effect)

In the latter case, life-threatening side effects may appear in the form of cardiac arrhythmias, hypertensive crisis, hemorrhages, liver, kidney and bone marrow damage.

For example, the concomitant intake of oral anticoagulants with non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of gastrointestinal bleeding in the elderly by almost 13%.

Elderly people - due to their age and frequent multiple diseases (and hence - taking many medications) - are particularly vulnerable to adverse drug effects.

You can not combine medicinal charcoal with other drugs, cholestyramine (reduces cholesterol) with warfarin (a drug against blood clots) or digoxin (increases the strength of heart contraction) or antacids in the stomach with aspirin and other drugs of the nature of acidic as they prevent them from being absorbed from the digestive tract.

Interact withmedications may also include dietary supplements and some foods. For example, grapefruit juice can increase the concentration of calcium antagonists in the blood up to a 3-fold. It also increases the concentration of antihistamines, which can lead to arrhythmias. In turn, vitamin E increases the effect of warfarin, increasing the risk of bleeding.

This will be useful to you

Polypharmacy - how to avoid it?

1. Start with low doses, increasing gradually as needed.

2. Use medication for the shortest possible time.

3. Use the simplest dosing schedules possible.

4. Choose drugs that are well known, with a long history of documenting their safety and effectiveness.

Source:

Biercewicz M., Szrajda J., Haor B., Kędziora-Kornatowska K., Polipragmazja - an important issue in the care of elderly patients, "Problems of nursing" 2012

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He alth