EM Cases · Polypharmacy and adverse drug events
Anticoagulant-associated major bleed with polypharmacy
ACEM Fellowship station on ADE recognition, BPMH, high-risk drug classes, and post-event deprescribing.
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Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
Frail older adult on five-plus medicines including an anticoagulant presents with GI bleeding and orthostatic syncope — reverse, reconcile, deprescribe.
Station brief
Format. Clinical-management station, 11 minutes. You are the EM consultant.
References2ShowHide
- [1]Hajjar ER, Cafiero AC, Hanlon JT Polypharmacy in elderly patients. The American Journal of Geriatric Pharmacotherapy, 2007.PMID 18179993
- [2]O'Mahony D, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age and Ageing, 2015.PMID 25324330