184 - Drop it Like it’s Hot! Deprescribing Pharmacotherapy When Appropriate
HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast
Sean P. Kane, PharmD, BCPS
5 • 644 Ratings
🗓️ 9 August 2024
⏱️ 39 minutes
🧾️ Download transcript
Summary
In this episode, we discuss the approach to deprescribing for several drugs such as benzodiazepine receptor agonists, cholinesterase inhibitors, memantine, antipsychotics, and antihyperglycemics.
Key Concepts
- Medication appropriateness including indication and risk vs. benefit should be evaluated for all stages of life; however, more importantly in older individuals to address polypharmacy.
- There is an emerging trend of deprescribing networks that conduct research and provide evidence-based recommendations for how to deprescribe certain medications used for specific indications.
- Evidence-based deprescribing guidelines for PPIs, benzodiazepines, benzodiazepine receptor agonists, opioids, antipsychotics, cholinesterase inhibitors, memantine, and antihyperglycemics are available for patient-provider shared decision making.
- A general deprescribing approach is gradual tapering of the drug leading to discontinuation over several weeks while monitoring patients for withdrawal symptoms or benefits of discontinuation.
References
- http://deprescribing.org
- https://www.australiandeprescribingnetwork.com.au
Transcript
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| 0:00.0 | Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions. |
| 0:11.0 | This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy. |
| 0:17.0 | This podcast contains general information for educational purposes only. This is not professional |
| 0:22.4 | advice and should not be used in lieu of obtaining advice from a qualified health care provider. |
| 0:27.2 | And now on to the show. Welcome to Helix Talk, episode 184. I'm your co-host, Dr. Kane. |
| 0:35.9 | And I'm Dr. Patel. And the title of today's episode is |
| 0:39.4 | drop it like it's hot, deprescribing pharmacotherapy when appropriate. So Dr. Patel, clearly we're |
| 0:45.0 | talking about getting rid of medications. And this is actually not a new topic for us in terms of |
| 0:49.5 | Helix Talk covering the concept of deprescribing and kind of how to do it. |
| 0:54.7 | Yeah. |
| 1:00.3 | So back in episode 57, we kind of talked about use and overuse of PPIs. And then we did another episode about deprescribing PPI's, which was episode 129. |
| 1:06.2 | And then back with Dr. Michael Schumann, we also discussed, you know, benzodiazepine taper. |
| 1:11.1 | So it's not really deep prescribing, but like tapering off unnecessary benzodiazepine. |
| 1:15.4 | This was in episode 68. |
| 1:18.0 | Today's episode, we're not focusing on these discussions because they already happened in the past, |
| 1:22.7 | but we're going to focus on drugs such as the benzodiazepine receptor agonist, |
| 1:26.9 | colon astorase inhibitors, |
| 1:28.5 | Mimantin, antipsychotics, and antipycimics. For these drugs, there are set guidelines or |
| 1:35.5 | guidance out there, and that's the reason why we're focusing on these. And, you know, deprescribing |
| 1:40.6 | might be a new term for people. I think most people kind of intuitively understand |
| 1:44.5 | it's where you get rid of a medication, but it's a little bit more than just getting rid of it. |
| 1:48.7 | It's like the planned process of how do you taper off if you need to taper down the dose, |
... |
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