How one drug leads to another? Prescribing cascade

MBBS
1

A prescription cascade occurs when a side-effect of medicine is mistaken for a new medical condition leading to the prescription of an additional drug. Overtime, this results in unnecessary polypharmacy, increased adverse effect and higher healthcare costs.

For example, a patient taking a calcium channel blocker may develop ankle edema. Instead of identifying it is a drug side-effect, a diuretics may be added. Similarly, NSAID induced gastric irritation may be treated with long-term acid suppressants, or antipsychotic induce tremors may be misdiagnosed as Parkinson’s disease. Each added medicine increases the risk of further side effect, creating full cycle.

Have you ever prescribed a new medicine to side effect mistaken as new diagnosis or you have any example to share?

MBH/PS

4 Likes
2

yes it s.because whats not natural wont come to you without side effect..and cascade will be there.but frequent blood test and evaluation can help to sought it out

3

Every added pill can be a chain reaction, so potting the side effects early prevents the spiral.

4

Knowing the side effects of drugs that we are prescribing is absolutely necessary.

5

Comprehensive history taking is a must as some patients may not come forward with the entire list of medications when asked the first time.