Re: [Gnumed-devel] further thinking on list of current medications

[Jim Busser]

At the risk of making you sorry you asked the question, what about a  
single-component drug used for more than one condition
- beta-blocker or calcium antagonist used for migraine prophylaxis  
and hypertension
- diltiazem or verapamil used for control of atrial fibrillation rate  
plus angina
- angiotensin converting enzyme inhibitor used for hypertension and  
heart failure

Maybe the frame of capture is the encounter and in that encounter  
whichever condition-encountlet most attracted this clinical decision  
and action --- no matter if it was a first-time prescription or an  
increase in dosage when the patient was already on the medication for  
something else --- could serve as the point of reference for this  
action. In the soap note, the clinician could choose to enter some  
words to show their awareness of the multiple-actions, if they were  
not already making a separate entry in the encountlet relating to the  
other-affected condition.

I suppose the same is true of a drug that is being prescribed to help  
one condition with the knowledge that it could worsen another known  
condition. Sometimes we do this hoping that the other condition is  
not (or is not badly) aggravated. Some way of visualizing this  
linkage might help to protect us from the risk of such actions. I am  
not suggesting that the visualization be built in the current-next  
client but it might be good to think about the schematic relationships.

On 31-Mar-09, at 9:25 AM, Karsten Hilbert wrote:

> Hello,
>
> can anyone think of a multi-component drug where the
> components do NOT target the same affliction (episode) ?
>
> Say, a combination of Simvastatin and Metformin ...
>
> And, no, Paracetamol + Codein/Coffein doesn't count ;-)
>
> Karsten
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