Real Life Examples: Polypharmacy and the Prescribing Cascade Part 2 of 2

Polypharmacy is one of the most common—and often overlooked—challenges in modern healthcare, especially in older adults. It’s not just about the number of medications a patient is taking, but whether each one still has a clear indication, is providing benefit, and isn’t causing harm. As medication lists grow, so does the risk of adverse effects, drug interactions, and something we see all the time in practice: the prescribing cascade.

A prescribing cascade happens when a medication causes a side effect that is misinterpreted as a new medical condition, leading to the addition of another drug. Over time, this can snowball into unnecessary complexity and increased risk for patients.

In part 2 of this podcast, we outline 5 more examples that I’ve encountered in my geriatric pharmacist practice.

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Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

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Pharmacy Technician Study Guide by Meded101

10 Commandments of Polypharmacy Part 2 of 2

clear plastic container and medicine capsule

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Here is part 2 of 2 on the final 5 of the 10 commandments of polypharmacy.

6. Thou shalt identify limits for medications not intended for chronic use as well as not continue a medication indefinitely for symptoms that have an expected short duration

7. Thou shalt not start a medication from a similar medication class without appropriate rationale

8. Thou shalt not initiate a medication without considering medications that may treat duplicate conditions – Kill two birds with one stone

9. Thou shalt consider eliminating or reducing medications at every medication review

10. Thou shalt be willing to accept risk in discontinuing a medication if they were willing to accept the risk of initiating a medication

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

Support The Podcast and Check Out These Amazing Resources!

NAPLEX Study Materials

BCPS Study Materials

BCACP Study Materials

BCGP Study Materials

BCMTMS Study Materials

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

Pharmacy Technician Study Guide by Meded101