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Drug Utilization Review: A Description of Use for a Medicaid Population (Maryland) 1986–1994

Published online by Cambridge University Press:  01 January 2021

Extract

A relatively healthy forty-six-year-old woman with mild hypertension receives a prescription for an antihypertensive medication. One of the medication's adverse effects is its potential to cause severe depression. Four months later, she is diagnosed with anxiety, an early manifestation of depression. An antianxiety drug is prescribed, but her anxiety worsens. Her physician then diagnoses her as having a depressive disorder, and prescribes a new antidepressant medication. She is still on the same antihypertensive.

A seventy-two-year-old man is given furosemide and digoxin to control a mild case of congestive heart failure and hypertension. Because furosemide deletes potassium from the body, his physician also places him on a potassium supplement. Six months later, the physician tells the patient to stop taking the furosemide and prescribes an angiotensin converting enzyme (ACE) inhibitor. An effect of ACE inhibitors is to reduce the body's excretion of potassium thereby reducing the digoxin's effectiveness.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1994

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References

Lewin-VHI, “Savings from a Medicare Pharmaceutical Benefit,” prepared for the National Association of Chain Drug Stores, Feb. 18, 1994.Google Scholar
This report is now out of print and unavailable from HCFA, so far as I can ascertain. The information was obtained from Health Information Designs, of Alexandria, Virginia.Google Scholar
Le Roy, Aida Morris, Lee, Study of the Impact of Inappropriate Ambulatory Drug Therapy on Hospitalizations, (Washington, D.C.: U.S. Government Printing Office, HEW Publication, January 1978). This study also is out of print, and no longer available from the Government Printing Office. The information was obtained verbally from the authors.Google Scholar