dingding replied: "I can only comment on the diabetes-related ones. You're right that this is an extensive list, but since they are for various conditions, they may all be necessary. My main concern would be if any of these medications are canceling each other out in any way. The best thing to do is make an appointment with your pharmacist to stop by and have him review the list - they are usually happy to do so if you set time aside with them:
Test my blood sugar levelACCUCHEK 3x daily (this is good and normal for someone with Type 2 diabetes)
DiabetesGLYBURIDE-METFORMIN 2.5/500 2 tablets 2x daily (is this necessary when she is also on insulin? For some Type 2's it is, but I would check into it)
DiabetesHUMULIN N 88 morn 74 night / DiabetesHUMALOG 12 u 16 u 14u
(why is she taking TWO kinds of fast-acting insulin? Humalog works better and faster, the Humulin dose must be incorrect - it's way too high, are you sure it's Humulin and not NPH or Lantus?)
NeedlesSYRINGES 1ML/30G shot 3x daily (yup, the insulin's got to get into her somehow!)"
LovePharmacy replied: "Blood pressure: Cartia, Diovan, HCTZ
Diabetes: Glyburide-Metformin, insulins, test strips, syringes
Cholesterol: Lovastatin, Colestipol , gemfibrozil
Urinary incontinence: oxybutynin
Allergies: Fluticasone
Anxiety: paroxetine
Pain: tramadol
I wrote out her meds like this so it would be easier for me to see. I know that all together, she is taking a lot of meds. But when you look at them according to each disease state, she's really not taking that many meds. I've seen much worse (upwards of 20 rxs per day).
Blood pressure ususally requires 2-3 meds to control it. It's fairly standard to use a water pill plus other agents.
Note: colestipol is not really a poop medicine. It's to bring down LDL cholesterol. It binds bild acids in the intestine. Since there are less bile-acids (cause they are all bound up), the body converts cholesterol into bile-acids. It's a way that we trick the body to decrease LDL. The bile acid that is bound to colestipol will be pooped out. I'm assuming the dr placed her on colestipol after seeing that lovastatin wasn't bringing her LDL down enough.
Note: one contributor said the Humulin N doses were too high. That may or may not be true. If your wife's glucose levels are adequately controlled, then that may just be what she needs. If they were outrageously high, she would have crashed by now.
It's a little strange that she is on glyburide-metformin. Once a patient is started on insulin, glyburide is usually dropped. Glyburide forces the body to secrete more insulin. So once a patient needs exogenous insulin, then there is no point in forcing the body to make it. Metformin is usually kept because it improves the body's response/sensitivity to insulin. May want to ask doctor if she should just receive metformin (way cheaper too).
Bottom line: I think she's okay. Each of her disease states are being managed and the pre ions don't look crazy or out of context.
You should encourage (not badger) her to exercise. That would help her blood pressure, diabetes, cholesterol levels, anxiety, and allergies. Also, dietary changes are great too. If she makes a serious committment to lifestyle changes, she could decrease her dependence on pre ions.
Being that she is on so many meds, she should stick to one pharmacy that you guys like. That way, even if she sees multiple doctors, there shouldn't be a duplication in therapy. Also, they can check for drug interactions. If she goes to multiple doctors, she may run into a drug problem and no one in her health-care team has any idea about it."
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