Polypharmacy: a case report and new protocol for management.
BACKGROUND
Polypharmacy is an important issue in primary care, yet few data are available concerning its prevalence, complications, and management in clinical medicine. The following case illustrates the clinical perils of polypharmacy and serves as a point for critical discussion.


METHODS
MEDLINE was searched, using the key word "polypharmacy," from 1994 to the present. A case report of polypharmacy is described, and a novel protocol for the management of polypharmacy is proposed.


RESULTS
Polypharmacy can lead to unnecessary expense, wasted time, and embarrassment on the part of the patient and confusion and mismanagement on the part of the physician. The literature reveals controversy surrounding the definition of polypharmacy and reflects the considerable morbidity and expense associated with polypharmacy. Finally, the SAIL protocol shows that physicians need to keep in mind simplicity, adverse effects, indications, and a precise list of all medications to manage appropriately a patient's drug regimen.


CONCLUSIONS
Polypharmacy is associated with morbidity and iatrogenic complications. The SAIL protocol can be a useful tool in the management of this entity. More research needs to be done on the prevalence, complications, and management of polypharmacy.
Lee
R D
RD
Blackstone Family Practice Center, Department of Family Practice, Medical College of Virginia, Richmond, USA.
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics; D002216:Captopril / Q000008:administration & dosage; D003000:Clonidine / Q000008:administration & dosage; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D017292:Doxazosin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005905:Glyburide / Q000008:administration & dosage; D017408:Guidelines as Topic; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D017706:Lisinopril / Q000008:administration & dosage; D008687:Metformin / Q000008:administration & dosage; D008790:Metoprolol / Q000008:administration & dosage; D019338:Polypharmacy; D014481:United States; D014700:Verapamil / Q000008:administration & dosage
D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D008687:Metformin; D002216:Captopril; D014700:Verapamil; D017706:Lisinopril; D008790:Metoprolol; D003000:Clonidine; D017292:Doxazosin; D005905:Glyburide