Respond to your classmates opinions, providing support for your post.
I need response for two students for student A post and Student B post
There are many reasons that a physician would use a drug for off-label purposes. One specific reason is that when the drug was given to a patient and it was found to be helpful for more than the original intended use. One such example would be Wellbutrin. The FDA has this drug listed for treatment of depression but it is commonly used off-label for smoking cessation. Physicians are allowed to use prescription drugs off-label without telling the patient. In the instance of Wellbutrin I can see why it is being used off-label and agree with its use. But not informing the patient of why you are prescribing a drug is unethical as well as not telling a patient that the drug they are being prescribed is being used in a way not originally intended by the maker or listed by the FDA.
Polypharmacy is the use of four or more medications at a time. The use of a drug off-label could cause many adverse reactions and serious problems for the patient. Pharmacies try to keep up with what patients are taking and when they are prescribed something new they try to make sure the patient isn’t taking something that could cause adverse reactions by giving patient information sheets with the medications that literally spell out other drugs and even foods or drink that could cause any problems. They list signs to look for and what to do when an adverse reaction occurs. If the reaction could be severely extreme they will sometimes put a specific warning label on the medication bottle. But as with anything you can only do so much before you have to leave it up to the patient to take an active part in their health care.
Some potential problems for the elderly and off-label drug use are obviously adverse reactions, problems remembering to take specific medicines at specific times, overdose and even such things as one drug is being used for ng four or more medications at a time. The use of a drug off-label could cause many adverse reactions and serious problems for the patient such as a patient could be taking a specific medication for thinning their blood but then the doctor puts them on drug for off-label purposes that reverses the effect of the other drug.
1. Based on your research, why would a physician use a drug for off-label purposes? Give one example of such a drug and why you think it should or should not be used.
Off Label drug use (OLDU) simply means using a drug for a purose the FDA did not approve on the label. All drugs have side effects and some of these can be beneficial. Postoperative nausea and vomiting is a problem often resolved with bolus doeses of propofol and dexamethasone; both off which are not labeled for this use. (Wittich, Burkle & Lanier; 2012) I think if the benefit to the patient outweighs the risk then the doctor should be able to determine if it can be used or not. It’s his malpractice case if he makes the wrong decision.
2. How might polypharmacy affect off-label drug use?
Due to the various ways in which drugs interact with each other; OLDU may be affected by the patients current medication list. If the drug has a negative reaction with the medications the person is taking an unnecessary risk may be presented by using the drug.
3. Based on the information in this lesson and your research, what are some potential problems related to off-label drug use for elderly patients?
The physiological changes that happen with age change how drugs are utilized by the body. Changes in absorption, distribution, metabolism and excretion all occur as organs age and function differently. (Woodrow, Colbert, Smith; 2015) This effects dosing and usage of the drug over time. With personal experience of caring for an elderly parent for a while, they tend to know what pills to take when, but may not know the pills names or what they are actually taking them for. This poses a problem if the drug is being used for an off label purpose and then another drug is prescribed to accomplish the same effect. This can lead to toxic buildups of medication in the body and overdosing as well. Geriatric doctors should be well versed in these changes and adjust medications as necessary.
Wittich, Christopher M,M.D., PharmD., Burkle, Christopher M,M.D., J.D., & Lanier, W. L., M.D. (2012). Ten common questions (and their answers) about off-label drug use. Mayo Clinic Proceedings, 87(10), 982-90. Retrieved from http://search.proquest.com/docview/1095794180?accountid=89121
Woodrow, R., Colbert, B., & Smith, D.; (2015) Essentials of Pharmacology For Health Professions; USA; Cengage Learning
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