Medical practice in the US would benefit from an improved understanding of pharmacokinetics, especially in combination with polypharmacy. Whether through lack of time (a real problem) or being bound by prior experience they often struggle with titration. I have a recent example.
I’m a 77 yo, and like many men my age I take more medications than I have ailments. Earlier this summer a new doctor prescribed a drug at a common dosage of 25 mg. It began to have the desired effect but at a cost of excessive daytime sleepiness, so I reduced the dose to 12.5 mg. Same problem. Then 6.25 mg, no difference.
I went off for 10 days before the effect subsided but happily the complaint I was taking it for also resolved.
But then I got curious. So, I find out that the drug has a 2 hour ramp and a 20-hour half-life. I graph it and see that the highs and lows climb before reaching a steady state higher than the administered dosage.
I’m sorry you had that experience, but glad you were able to work through it and figure out a way forward.
You’re right, a lot of healthcare practitioners either don’t know too much about drugs, or are so overloaded they can’t give it the attention it needs, or some combination of both. That’s why I think it’s so important for people to be the most active part of their healthcare team they can be.
Medical practice in the US would benefit from an improved understanding of pharmacokinetics, especially in combination with polypharmacy. Whether through lack of time (a real problem) or being bound by prior experience they often struggle with titration. I have a recent example.
I’m a 77 yo, and like many men my age I take more medications than I have ailments. Earlier this summer a new doctor prescribed a drug at a common dosage of 25 mg. It began to have the desired effect but at a cost of excessive daytime sleepiness, so I reduced the dose to 12.5 mg. Same problem. Then 6.25 mg, no difference.
I went off for 10 days before the effect subsided but happily the complaint I was taking it for also resolved.
But then I got curious. So, I find out that the drug has a 2 hour ramp and a 20-hour half-life. I graph it and see that the highs and lows climb before reaching a steady state higher than the administered dosage.
Go figure.
Thanks for reading and commenting Richard.
I’m sorry you had that experience, but glad you were able to work through it and figure out a way forward.
You’re right, a lot of healthcare practitioners either don’t know too much about drugs, or are so overloaded they can’t give it the attention it needs, or some combination of both. That’s why I think it’s so important for people to be the most active part of their healthcare team they can be.