Real Life Examples: Polypharmacy and the Prescribing Cascade Part 2 of 2
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist
4.9 • 773 Ratings
🗓️ 30 April 2026
⏱️ 15 minutes
🔗️ Recording | iTunes | RSS
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Summary
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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Transcript
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| 0:00.0 | Hey all, welcome back to the real life pharmacology podcast. Thanks so much for listening today. |
| 0:05.2 | I'm your host, Eric Christensen. I am a pharmacist, and I primarily work in geriatrics, and that's |
| 0:11.2 | what I'm going to share a little bit about today. Really going to cover some polypharmacy cases and |
| 0:17.5 | examples. This is part two, part two of two, I guess if you will. I just jotted down some |
| 0:26.3 | recent examples I had seen in practice over the last three to six months and just wanted to |
| 0:31.9 | share those examples with you because this is stuff that I see on a fairly regular basis. |
| 0:38.7 | So before I get into that, reminder, I've got the geriatric review course at MedEd101.com |
| 0:45.6 | slash store geared towards pharmacists, but again, anybody could definitely benefit from that |
| 0:51.7 | if you're looking for more pharmacology, pharmacotherapy |
| 0:55.0 | type of education. |
| 0:57.5 | I got stuff on other board certifications as well for pharmacists, BcPS, ambulatory care, |
| 1:05.1 | geriatrics, BCMTMS, lots of good stuff at Medit 101.com slash store. |
| 1:10.1 | So go check that out. |
| 1:11.4 | In relation to this podcast episode, I do have a book called Perils of Polypharmacy on Amazon. |
| 1:20.0 | It's received a lot of really kind and nice reviews over time. |
| 1:24.6 | Definitely a great resource if you're working in geriatrics, |
| 1:28.7 | learning how to identify medications that we can reduce, |
| 1:34.3 | recognizing cases and situations, |
| 1:36.8 | and really just honing in your focus on polypharmacy, |
| 1:41.0 | deprescribing, and how to improve the lives of our patients and make |
| 1:45.8 | medication regimens more simple. |
| 1:48.7 | Okay. |
... |
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