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Pharmacy/Too Many Pills?


QUESTION: I need to first say that I recognize that I do not have 'continuity of care' in so far as I see / have seen a Parkinson's specialist and a general practitioner (denoted as Dr A) in the UK and a general practitioner in California (denoted as Dr B);  additionally I was seen by two hospital doctors (Dr C) in California (Nov 2013) when it was thought I might have had a TIA.  I have the highest regard for all and make every effort to keep them all aware of what I am taking but begin to wonder whether I am on too many meds.

My current schedule is:
0830 am
1 x Metformin 500mg from1 May 2014 following recent blood tests Dr B.
1 x Atenolol 50mg; Dr A
1 x Diovan 360mg; Dr B
1 x baby aspirin;  
1 x Madopar (senimet - levidopa) 100mg/25mg; Dr A
1 x Ropinerol 2mg Dr A
1 x Pradaxa 150mg Dr C
1 x hydrochlorothiazide 25mg Dr B

Mid Day
1 x Madopar Dr A
1 x crestor 50mg Dr A

1 x Madopar Dr A

1 x Madopar Dr A
1 x Ropinerol Dr A
1 x Tamsulosin  Dr B
1 x Pradaxa 150mg Dr C

Interspersed as remembered multivitamin plus Calcium & Vitamin to make up 1000IU of Vitamin D3 Dr B

My family asks me whether I am taking too many pills and I wonder too.

ANSWER: Hi,David,
There are a few questions I would need to ask you to determine if you are taking too much medication.
1)how old are you?
2) besides Parkinson's disease, what other medical conditions are they treating?
3) do you have any kidney or liver problems?
4) do you feel as though you are being over-medicated? ie do you have side-effects such as drowsiness, dizziness, confusion, fatigue on an ongoing basis?

---------- FOLLOW-UP ----------

QUESTION: In response to your questions, thank you
1) I will be 71 at the end of this week and conscious that PD is advancing gradually.
2) I have high blood pressure - everybody in my family seems to have high BP and I've had it for a few years -  and (I believe like most men of my age) the waterworks is playing up;  when I gotta go I GOTTA go -even if it is usually less than a decent wine-glass amount
3) Dr B specifically called to tell me that my most recent blood tests about a week ago were all fine for PSA, liver, kidney etc the only issue being high blood sugar which led to starting on Metformin.
4) yes, I do now have a nap during the day and the day I started the Metformin I felt slightly light headed as if I had had a couple of cocktails.

I just feel that I am now on close to 20 pills a day - for somebody who till mid 50's rarely took an aspirin - if that's OK, then fine but I am grateful for your consideration of the matter as a cross-check

The only med I would question at this point would be the Metformin. If it was just a case of high blood sugar at some point and not a diagnosis of Type 2 diabetes, you may not need it. Has there been additional tests such as a hemoglobin A1c? This would give an idea of whether your blood sugar is high over a longer period of time. Watching your diet and consistent amount of exercise can keep blood sugar in control.
Also, checking your blood pressure at least weekly at home can give you a better idea of how your blood pressure meds are working. As people age, lower blood pressures can be as bad as higher blood pressures,especially with Parkinson's disease. Lower blood pressures can increase the risk of falls. You want to have systolic blood pressure no less than 120-125 (the top number). Taking your blood pressure at home lessens the risk of having the reading distorted by "white coat syndrome". If your blood pressure reads higher in the doctor's office, the physician is more apt to increase  your dose or add an additional blood pressure med. Currently you are taking Diovan, hydrochlorothiazide, Flomax and atenolol, all of which lower blood pressure.
Hope this helps, Mary


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Mary E Scott, RPh, CGP


I am a certified geriatric pharmacist with over 23 years experience as a long-term care consultant to nursing homes. I also do community-based consulting on an individual basis. My facility-based monthly newsletter on pharmacy topics is read by nurses in over 200 long-term care facilities in 5 states.


I received a BS in Pharmacy in 1980 with post-graduate work in public health. I have had a Consultant Pharmacist license since 1984.

American Society of Consultant Pharmacists
.I received certification in geriatric pharmacy in 1998.

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