Navigating the perils of polypharmacy: A clinical pharmacology case study from elderly patient care

Polypharmacy is increasingly prevalent among elderly populations due to multimorbidity and the expansion of pharmaceutical options. This case report explores the adverse effects of polypharmacy in an elderly patient, emphasizing the importance of appropriate medication management and the role of clinical pharmacologists. A 78-year-old male with multiple comorbidities was discharged with a complex medication regimen from a hospital in West Bengal. Within 5 days, he experienced severe complications including QT prolongation and a significant fall resulting in a femur fracture. These events were precipitated by the interactions among multiple prescribed medications and a previously unreported use of a fixed-dose combination of paroxetine and clonazepam. The case underscores the dangers of polypharmacy, particularly the risk of adverse drug reactions such as QT prolongation and potential torsades de pointes, exacerbated by drug-drug interactions and electrolyte imbalances. It highlights the necessity of comprehensive medication reconciliation and the critical role of clinical pharmacologists in managing complex medication regimens. This case advocates for the integration of clinical pharmacologists into health-care settings to enhance medication safety and efficacy, particularly in elderly patients with polypharmacy. The involvement of pharmacologically trained professionals can significantly mitigate medication-related risks and improve patient outcomes.