Some things to consider when a drug is being prescribed.
How the drug is processed in the body.
Kidney function and liver function are important patient considerations. Certain drugs are processed by the liver for example, and active liver disease may mean choosing an alternative or adjusting dose. Compromised kidney function needs to be considered with drugs that are processed thru the kidney. (some drugs are processed by the liver & the kidney, and these might be considered for those with impairment of either kidney or liver).
Potential drug disease issues.
Certain drug classes are avoided (when possible) that might have an adverse effect on a patient who has other disease states or conditions. A patient's asthma for example, may worsen with drugs from a particular class (Beta blockers). A drug that causes tremors for a diabetic patient needing to inject insulin could be problematic.
Potential drug drug interactions.
Especially challenging when you put several drugs in the same basket. There is a lot of information about drug drug interactions
between two drugs. Evaluating several and sometimes many drugs in a basket, which is often the case with multiple disease states, is difficult. There are some great sites for health professionals with tools to compare lists of drugs together.
(vitamins,herbs/natural health products, other over the counter drugs being taken need to be included in this evaluation). Pharmacists can be a good resource for this kind of information.
Possible duplication of therapy.
There are many disease states that require multiple drugs as part of the treatment regimen. Sometimes duplication of therapy (2nd drug added to augment the 1st drug) is necessary, and sometimes it is not appropriate.
Other patient specific considerations.
Age. The elderly for example are at greater risk of falls with benzodiazepines, and the risk of a fall needs to be considered.
Ethnic group. Certain ethnic groups process drugs differently than others. The effectiveness of certain drug classes can differ depending on ethnicity.
***. Some drugs are processed differently by women vs men.
Compliance. How many doses a drug will be given daily. A drug requiring 3 or 4 doses throughout day, rather than once or twice daily dosing
will reduce the likelihood of compliance. Are blister packs appropriate when complicated drug regimens need to be used? Does the patient have a caregiver that can assist?
Patient history with respect to drug therapy. Has this patient been on this medication before? Did it work? Was it well tolerated? Should a drug with different properties be used in the present situation?
This list is by no means exhaustive
How the drug is processed in the body.
Kidney function and liver function are important patient considerations. Certain drugs are processed by the liver for example, and active liver disease may mean choosing an alternative or adjusting dose. Compromised kidney function needs to be considered with drugs that are processed thru the kidney. (some drugs are processed by the liver & the kidney, and these might be considered for those with impairment of either kidney or liver).
Potential drug disease issues.
Certain drug classes are avoided (when possible) that might have an adverse effect on a patient who has other disease states or conditions. A patient's asthma for example, may worsen with drugs from a particular class (Beta blockers). A drug that causes tremors for a diabetic patient needing to inject insulin could be problematic.
Potential drug drug interactions.
Especially challenging when you put several drugs in the same basket. There is a lot of information about drug drug interactions
between two drugs. Evaluating several and sometimes many drugs in a basket, which is often the case with multiple disease states, is difficult. There are some great sites for health professionals with tools to compare lists of drugs together.
(vitamins,herbs/natural health products, other over the counter drugs being taken need to be included in this evaluation). Pharmacists can be a good resource for this kind of information.
Possible duplication of therapy.
There are many disease states that require multiple drugs as part of the treatment regimen. Sometimes duplication of therapy (2nd drug added to augment the 1st drug) is necessary, and sometimes it is not appropriate.
Other patient specific considerations.
Age. The elderly for example are at greater risk of falls with benzodiazepines, and the risk of a fall needs to be considered.
Ethnic group. Certain ethnic groups process drugs differently than others. The effectiveness of certain drug classes can differ depending on ethnicity.
***. Some drugs are processed differently by women vs men.
Compliance. How many doses a drug will be given daily. A drug requiring 3 or 4 doses throughout day, rather than once or twice daily dosing
will reduce the likelihood of compliance. Are blister packs appropriate when complicated drug regimens need to be used? Does the patient have a caregiver that can assist?
Patient history with respect to drug therapy. Has this patient been on this medication before? Did it work? Was it well tolerated? Should a drug with different properties be used in the present situation?
This list is by no means exhaustive
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