“If the whole materia medica, as now used, could be sunk to the bottom of the sea, it would be all the better for mankind-and all the worse for the fishes”.
-Dr. Oliver Wendell Holmes Senior
There is a hidden epidemic, one of overprescription. Polypharmacy, in context, often refers to prescription, administration and usage of more than five drugs. Adverse drug reactions increases on the increasing use of medications. Patient safety is highly compromised in the situation of multi-drug use.
Based on evidence-based practice, it is categorised into appropriate polypharmacy and inappropriate polypharmacy. Appropriate polypharmacy provides the much needed therapy and reduces the risk of adverse drug reactions. Inappropriate polypharmacy is when the indication no longer serves it’s value or the dose is exceedingly high for the patient’s particular health profile creating a high probability of numerous adverse drug reactions. Rise of multi-morbidity, ageing population, evidence-based medicine, pressures in immediate positive health outcomes for the patient are all the sources of this problem.
Multi-morbidity refers to two or more long term health conditions that are not limited to physical and mental conditions, disabilities, chronic pain, sensory impairment, including any type of substance abuse. Deprescribing is a crucial step in solving the problems associated with overprescription. It involves stopping and withdrawal of the prescribed drug and dosage.
May 7 is National Fentanyl Awareness Day. Many people fall prey to overdosage and death from this synthetic opioid that is 50 times more potent than heroin. This is an illegal weapon of choice for people suffering from mental disorders and people who do not know how to manage their stress. It has deadly effects even when used in lower concentrations and is also available over the counter. Naloxone is the preferred antidote.
Inappropriate use of antimicrobials leads to organism resistance. There are five mechanisms by which it occurs: enzymatic inactivation, target modification, immunity and bypass, and efflux. It can be natural antibiotic resistance or acquired antibiotic resistance. AMR prolongs hospital stay, makes medical procedures and treatments harder to treat and poses a serious threat to exposure from wastewater from inpatient care units. Children and the elderly are most likely to be susceptible.
Nivea Vaz
Manipal College of Medical Sciences







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