Work

Successful intervention to mitigate an acetylcholinesterase inhibitor-induced rhinorrhea prescribing cascade: a case report

Year: 2017

Type: article

Abstract: WHAT IS KNOWN AND OBJECTIVE: A prescribing cascade if often treated by discontinuing both medications. We describe an intervention to mitigate a prescribing cascade while continuing a clinically necessary medication without negatively impacting the patient. CASE SUMMARY: A 77-year-old women experienced probable acetylcholinesterase inhibitor-induced rhinorrhea and subsequently self-medicated with diphenhydramine which lead to worsening cognitive function. We reduced the dose of the acetylcholinesterase inhibitor and discontinued the diphenhydramine. The symptoms of rhinorrhea were subsequently reduced without negatively impacting cognition. WHAT IS NEW AND CONCLUSION: This was the first published prescribing cascade intervention that did not require discontinuation of both medications, which may be emulated in future prescribing cascade cases.

Source: Journal of Clinical Pharmacy and Therapeutics

DOI: 10.1111/jcpt.12511

Authors: S. M. Vouri, J. M. Chung, E. F. Binder

Institutions: University of Health Sciences and Pharmacy, Sisters of Mercy Health System, Washington University in St. Louis

Language: English

Topic: Pharmaceutical Practices and Patient Outcomes

Subfield: Geriatrics and Gerontology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: Institute of Clinical and Translational Sciences, National Institutes of Health, National Center for Advancing Translational Sciences