Affordable Access

Access to the full text

The Art of Safe and Judicious Deprescribing in an Elderly Patient: A Case Report

Authors
  • Gareri, Pietro
  • Gallelli, Luca1
  • Cotroneo, Antonino Maria
  • Manfredi, Valeria Graziella Laura
  • De Sarro, Giovambattista1
  • 1 Operative Unit of Clinical Pharmacology, University Hospital of Mater Domini Catanzaro, 88100 Catanzaro, Italy
Type
Published Article
Journal
Geriatrics
Publisher
MDPI
Publication Date
Sep 21, 2020
Volume
5
Issue
3
Identifiers
DOI: 10.3390/geriatrics5030057
PMID: 32967254
PMCID: PMC7554853
Source
PubMed Central
Keywords
License
Green

Abstract

Prescription for inappropriate drugs can be dangerous to the elderly due to the increased risk of adverse drug reactions and drug-interactions. In this manuscript, we report the complexity of polypharmacy and the possible harmful consequences in an old person. An 81-year-old man with a clinical history of diabetes, blood hypertension, non-valvular atrial fibrillation, chronic obstructive pulmonary disease, osteoarthritis, anxiety, and depression, was admitted to our attention for cognitive disorders and dementia. Brain magnetic resonance imaging showed parenchymal atrophy with lacunar state involving thalami and internal capsules. Neuropsychological tests revealed cognitive impairment and a depressed mood. History revealed that he was taking 11 different drug severy day with a potential risk of 55 drug–drug interactions. Therefore, risperidone, chlorpromazine, N -demethyl-diazepam, and L-DOPA/carbidopa were gradually discontinued and citicoline (1g/day), cholecalciferol (50,000 IU once a week), and escitalopram (5 mg/day) were started. Furthermore, he started a program of home rehabilitation. During the follow-up, three months later, we recorded an improvement in both mood and cognitive tests, as well as in walking ability. The present case report shows the need for a wise prescription and deprescribing in older people.

Report this publication

Statistics

Seen <100 times