The Happy Hospitalist - Latest Comments in http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

Anonymous — Tue, 13 Jan 2009 15:37:00 -0000

Looks like a fairly typical list we might get on a NH patient at our hospital. If you don't address them all on d/c, you get multiple phone calls from the floor staff asking if they can resume the pt's home meds.

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

Anonymous — Tue, 13 Jan 2009 12:23:00 -0000

Wow, just wow.

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

Toni Brayer MD — Tue, 13 Jan 2009 00:51:00 -0000

This list wins the
"poor medical care" award. Awful, shocking. And so many potential drug interactions! She might be less demented with fewer meds. Her physician should be reviewed by the medical board.

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

Anonymous — Tue, 13 Jan 2009 00:38:00 -0000

Combine felodopine and fosinopril with generic Lotrel. Why THREE different antidepressants? Is pt on MAX dose any ONE of these? Is buspirone maxed out so ativan can be PRN? Is quaitiapine (Seroquel) contributing to the increased blood sugar? If so, d/c it and metformin. Is the grim reaper lurking in this guy's closet?

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

kath8562 — Mon, 12 Jan 2009 21:32:00 -0000

Has stomach problems--naproxyn and asa ? oops.
And think they've got him on enough CNS depressants? Cut some of those out, starting with the Seroquel-- atypicals and dementia--no no! Bad!
Buspar and ativan? why?
There are so many things wrong with this list, even I, a lowly pharmacy tech, know that this guy would be much better off taking about half this crap!

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

kris — Mon, 12 Jan 2009 20:59:00 -0000

improve quarterly statements of pharmaceutical companies?

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

Anonymous — Mon, 12 Jan 2009 20:30:00 -0000

Constipation, or bowel obstruction secondary to 37 tablets?!?!? How very sad and lazy and wasteful, and how very frequently this goes on. Shameful.

Happy, please be encouraged to slash and burn. DC DC DC while this patient is in your capable hands. Maybe the poor soul's dementia will improve without all the CNS effects, and if the primary-psych-specialists get mad, who cares. They aren't worth getting such crappy referrals from anyway.

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

And so it goes — Mon, 12 Jan 2009 20:00:00 -0000

good God, i hope that pt has no c/o constipation...

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

Strong One — Mon, 12 Jan 2009 19:24:00 -0000

Err.. uhh.. thoroughness?? LOL

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

Frank Drackman — Mon, 12 Jan 2009 13:53:00 -0000

No Viagra!?!?! Oh the Humanity...

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

neon — Mon, 12 Jan 2009 12:52:00 -0000

Any why bother going over the Medication list to see if they are all needed? A new complaint-give'm another pill.

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

alexy — Mon, 12 Jan 2009 12:14:00 -0000

will this medication be significant to my patient? thats the question that many physician forget to ask sometimes. medications are meant to improve quality of life. in this case the goal of medication could be to kill the patient.

Re: http://thehappyhospitalist.blogspot.com/2009/01/polydementia.html

RantingAndRavingAngryPharmacis — Mon, 12 Jan 2009 12:03:00 -0000

My guess is more than one physician has been prescribing for this patient and none of the physicians know what the other prescibers are doing. Why hasn't the pharmacist filling all these prescriptions questioned the duplicated of therapy? The patient must have really good insurance--most insurances would have been questioning the duplicate of therapy, especially in the high cost drugs.