Reactions 1704, p265 - 2 Jun 2018 Various toxicities: case report A 74-year-old woman developed various toxicities including impaired driving ability, syncopal episodes, short term memory loss and impaired quality of life during treatment with alprazolam, gabapentin, paracetamol/diphenhydramine [diphenhydramine-acetaminophen], carbamazepine, oxybutynin and sodium chloride [routes and times to reactions onsets not stated]. The woman had a medical history of anxiety, hypertension and trigeminal neuralgia from 1970. She also had chronic hyponatraemia and overactive bladder. She presented with two syncopal episodes over the past two years. She also had short term memory loss and reduced stability. She was receiving treatment with alprazolam 1mg thrice a day, gabapentin 600mg thrice a day, paracetamol/ diphenhydramine 25-500mg one tablet every night, sodium chloride 3g thrice a day, carbamazepine 100mg, 100mg and 200mg three times a day and oxybutynin 10mg each night. Her adverse effects were considered to be related to the polypharmacy. The woman’s alprazolam, gabapentin, paracetamol/ diphenhydramine, carbamazepine and sodium chloride tablets were discontinued. Subsequently, she and her family reported improvement in the social interactions, restoration of memory and return to driving. Author comment: "[W]e determined the biggest contributor to her symptoms was poly-pharmacy." "We tapered off alprazolam, diphenhydramine-APAP, gabapentin, carbamazepine, and sodium tablets...Patient and family reported restoration of memory, improved social interactions, and a return to driving. " Parikh T, et al. Reducing polypharmacy to improve quality of life: Case study in de-prescribing to achieve optimal treatment plan. Journal of the American Geriatrics Society 66 (Suppl. 2): S191, 2018. Available from: URL: http:// doi.org/10.1111/jgs.15376 [abstract] - USA 803323621 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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