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Medication discontinuation is the ceasing of a medication treatment for a patient by either the clinician or the patient themself. [1] [2] When initiated by the clinician, it is known as deprescribing. [3] Medication discontinuation is an important medical practice that may be motivated by a number of reasons: [4] [3] Reducing polypharmacy
Drug withdrawal, drug withdrawal syndrome, or substance withdrawal syndrome [1] is the group of symptoms that occur upon the abrupt discontinuation or decrease in the intake of pharmaceutical or recreational drugs. In order for the symptoms of withdrawal to occur, one must have first developed a form of drug dependence.
The resulting hypothyroidism is treated with synthetic thyroid hormone. [1] Medications such as beta blockers may control the symptoms, and anti-thyroid medications such as methimazole may temporarily help people while other treatments are having an effect. [1] Surgery to remove the thyroid is another option. [1]
Deprescribing medications may improve patient function, generate a higher quality of life, and reduce bothersome signs and symptoms. Deprescribing has been shown to reduce the number of falls people experience but not to change the risk of having the first fall. [12] Most health outcomes remain unchanged as an effect of deprescribing.
Where risks or harms is the reason for withdrawal, this will usually have been prompted by unexpected adverse effects that were not detected during Phase III clinical trials, i.e. they were only made apparent from postmarketing surveillance data collected from the wider community over longer periods of time.
Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any symptoms or clinical changes, and may not require treatment.
For older people (over 50 years old) and people with known or suspected ischemic heart disease, levothyroxine therapy should not be initiated at the full replacement dose. [24] Since thyroid hormone increases the heart's oxygen demand by increasing heart rate and contractility, starting at higher doses may cause an acute coronary syndrome or an ...
Older people should be started on lower doses of liothyronine. [11] Plasma T 3 concentrations in this population are decreased by 25% to 40%. [ 9 ] TSH must be routinely monitored since there is a risk of coronary artery disease , hyperthyroidism and excessive bone loss from inadequate or abnormal thyroid replacement.
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