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Discussion

Multi drug interactions

I didn't want this to get lost on the other thread b/c I know some just read an opening post only and respond.

Thanks for all the tips btw.

Okay so if I'm understanding the interaction part. If it's listed in a guide (as someone mentioned drug guides are good for this) there's no way of knowing if a certain reaction is not the cause of one of the drugs but the combo of them?

For example I have someone who's wondering why I always have to give them insulin q day (usually only 2u) when before they hardly had to check theirs. Well she's on synthroid which I understand increases the insulin demand slightly.

Then she's on apresoline and lopressor (to name a few of her 34 meds :D) I got that the beta blocker is used to decrease the tachy from the other....all well and good. She worries about her Na retention, that's likely from the apresoline too.

Well now she's insisting that "something" is giving her a runny nose! Which she claims she's never had before. It could be as simple as the deep sea nasal spray she's on, although she blames that for the Na retention and not the apresoline. Which in my limited knowledge I think it's more the apresoline.

That's just one scenario. It just got me thinking that I wonder if someone develops a side effect from a combo of things could it be that "combo" causing it or is that too hard to determine unless it states in a drug guide that's an effect of either one of the drugs or combining things? And if it doesn't state that... is it too hard to say it's the interaction of x and y drug and that's what the doctors have to determine with trial and error?

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    Don't make yourself crazy with all these interactions. If they're not dangerous it's fine. I had a patient who complained to the doctor about always having a runny nose in the morning. He was going to add Claritin or something similar. I said...Dr. ..she takes 5 different nasal sprays every morning...it's probably that running out of her nose. He laughed...discontinued all but the most necessary spray and her runny nose was cured.

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    I try to give Synthroid alone simply because it tends to interact more than most meds. A lot of anti-Parkinson's drugs compete with others so watch those. Antacids interfere with everything. Always give those separately. Coumadin (warfarin) and Synthroid are a bad mix, but give them far apart.

    For the rest of it, there isn't much of an issue, and pharmacy will tell you, anyway.

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    I try to give Synthroid alone simply because it tends to interact more than most meds. A lot of anti-Parkinson's drugs compete with others so watch those. Antacids interfere with everything. Always give those separately. Coumadin (warfarin) and Synthroid are a bad mix, but give them far apart.

    For the rest of it, there isn't much of an issue, and pharmacy will tell you, anyway.

    Sue...could you enlighten me on the bolded?

    This concerns me, they had the time changed from 630am to the dinner pass b/c it wasn't working to wake the residents up, plus the additional work for the one night nurse.

    I swear the more I find out, the more disheartening, the more it conflicts with my own pharmaceutical issues, but in the meantime I gotta make do.

    btw Sue you have some great tips about organizing that I found in older threads, thanks for making an insane part of my journey a little saner!

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    Synthroid is usually given at 6:30 am since it's best given alone. Coumadin is usually given after 5 PM since it usually takes that long for lab results to get back and orders to be obtained. Call your pharmacy consultant if you have questions. That's what your facility is paying them for.

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