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Polypharmacy is one of the biggest dangers with the elderly population. The patients are being prescribed medications by the different specialists they go to . As Primary care providers we have to be aware of this danger and always ask patients to bring a list of medications to the clinic to review with the FNP. Patients should always be encouraged to inform their primary care provider of any newly prescribed medications. Polypharmacy should always be avoided because this may lead to drug interaction leading to adverse side effects or can affect the therapeutic levels of other medications, also can lead medication non adherence. Adverse effects can occur due to overstimulation of one medication caused by another and can cause complications in the patient that may worsen health or be non reversible or difficult to treat once occur. For example a patient that has a bad kidney can harm their kidney further if they take aspirin and other NSAIDs containing drugs if this patient also takes diuretic  and ace inhibitors for blood pressure this is putting the patient at high risk for decline in kidney function and can even lead to irreversible kidney damage (Beldowski, Hersh , Hajjar, 2017). 

Another safety concern with polypharmacy is drug interactions. Patient who take many medications at one time have a higher risk of having drug interactions. There are studies that prove that taking just 5 medication predisposes patients to 80% change of liver damage due to drug interactions during metabolism. There are different types of reactions one being antagonistic , and synergistic. When an antagonist reaction occurs it diminishes the effect of another medication reducing the therapeutic effect of the medication. A synergistic interaction causes an increase in the effect of a medication which can lead to OD and toxicity of a medication if not closely monitored (Allore, Gnjidic, Tinetti, 2017).

As a FNP we can take each visit as a chance to review all medications a patient is taking and encourage patients to report any new medications prescribed by other prescribers. As nurse practitioners we should also collaborate with other physicians to reduce the number of medications a patient takes to only the most important medications. At times patients are taking medications that are not medically necessary. As a FNP if this is suspected is is important to review with a physician and the patient in order to prevent polypharmacy. It is also important to encourage patients to always carry a list of medications with them wherever they go in case of emergency. 

Reference 

Hersh, L. R., Beldowski, K., & Hajjar, E. R. (2017). Polypharmacy in the geriatric oncology population. Current oncology reports, 19(11), 73.

Gnjidic, D., Tinetti, M., & Allore, H. G. (2017). Assessing medication burden and polypharmacy: finding the perfect measure.