Missed Opportunity to Deprescribe: Docusate for Constipation in Medical Inpatients

MacMillan, Thomas E.; Kamali, Reza; Cavalcanti, Rodrigo B.

doi:10.1016/j.amjmed.2016.04.008

Cited by 20 publications

(23 citation statements)

References 38 publications

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“…Facile protocols for assessing DOSS exposure and results provided herein could significantly aid in understanding the contribution of DOSS exposure during pregnancy to child metabolism, obesity and overall health. Several studies have highlighted the ineffectiveness of Colace to treat constipation, thus suggesting an opportunity to reduce prescription or eliminate use of this medication during pregnancy 105,106 .…”

Section: Discussionmentioning

confidence: 99%

Increased adiposity, inflammation, metabolic disruption and dyslipidemia in adult male offspring of DOSS treated C57BL/6 dams

Temkin

Bowers

Ulmer

et al. 2019

Sci Rep

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Evidence indicates that obesity can be promoted by chemical ‘obesogens’ that drive adiposity, hunger, inflammation and suppress metabolism. Dioctyl sodium sulfosuccinate (DOSS), a lipid emulsifier and candidate obesogen in vitro, is widely used in processed foods, cosmetics and as stool softener medicines commonly used during pregnancy. In vivo testing of DOSS was performed in a developmental origins of adult obesity model. Pregnant mice were orally administered vehicle control or DOSS at times and doses comparable to stool softener use during human pregnancy. All weaned offspring consumed only standard diet. Adult male but not female offspring of DOSS-treated dams showed significantly increased body mass, overall and visceral fat masses, and decreased bone area. They exhibited significant decreases in plasma adiponectin and increases in leptin, glucose intolerance and hyperinsulinemia. Inflammatory IL-6 was elevated, as was adipose Cox2 and Nox4 gene expressions, which may be associated with promoter DNA methylation changes. Multiple significant phospholipid/sterol lipid increases paralleled profiles from long-term high-fat diet induced obesity in males. Collectively, developmental DOSS exposure leads to increased adult adiposity, inflammation, metabolic disorder and dyslipidemia in offspring fed a standard diet, suggesting that pharmaceutical and other sources of DOSS taken during human pregnancy might contribute to long-term obesity-related health concerns in offspring.

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Section: Discussionmentioning

confidence: 99%

Increased adiposity, inflammation, metabolic disruption and dyslipidemia in adult male offspring of DOSS treated C57BL/6 dams

Temkin

Bowers

Ulmer

et al. 2019

Sci Rep

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show abstract

“…• Bisphosphonates for postmenopausal women to reduce fracture risk after 19 months 32 • Cholinesterase inhibitors and memantine for Alzheimer's disease after 12 months with cognition and/or functional status worsening 33 • Nonsteroidal antiinflammatory medications (NSAIDs) if symptoms have completely resolved 34,35 • Potentially inappropriate medications 37 • Proton pump inhibitors for GERD after 4 to 8 weeks [38][39][40] • HMG-CoA reductase Inhibitors (ie, Statins) for primary prevention of cerebrovascular events after 5 to 10 years [41][42] • Stool softeners 43 Abbreviations: ADEs, adverse drug events; GERD, gastroesophageal reflux disease. medication review time and positive impact on clinical inertia, and can measure an initiative's impact directly.…”

Section: Discussionmentioning

confidence: 99%

How to implement deprescribing into clinical practice

Pruskowski

Jeffery

Brandt

et al. 2021

J Am Coll Clin Pharm

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We currently live in the age of medication overload. More than 40% of older adults (≥65 years old) are prescribed ≥5 medications a day and nearly 20% take ≥10.Although medications can provide a wide variety of benefits, the number of medications prescribed is the largest predictor of drug-drug interactions, nonadherence, and most importantly adverse drug events. Increasingly, patients, caregivers, and health care providers are employing deprescribing efforts as a solution to medication overload. Clinical pharmacists are well positioned to lead and/or contribute to deprescribing efforts. Deprescribing, however, is not commonly and consistently taught within the United States health professional curriculums, and deprescribing infrastructure support is currently limited. The goal of this review is to present a pragmatic approach to pharmacist-driven clinical practice deprescribing implementation.

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“…Recent retrospective studies found that patients who were prescribed antipsychotics for the management of ICU delirium were receiving prescriptions for continued therapy upon discharge, despite resolution of delirium. 8,9 Another study, by MacMillan et al, 10 identified the unnecessary continuation of docusate despite its known ineffectiveness. These studies emphasize the importance of medication reconciliation at all points of transitions of care.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Deprescribing Amiodarone After New-Onset Atrial Fibrillation in Critical Illness

Leelathanalerk

Dongtai

Huckleberry

et al. 2017

The American Journal of Medicine

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Missed Opportunity to Deprescribe: Docusate for Constipation in Medical Inpatients

Cited by 20 publications

References 38 publications

Increased adiposity, inflammation, metabolic disruption and dyslipidemia in adult male offspring of DOSS treated C57BL/6 dams

Increased adiposity, inflammation, metabolic disruption and dyslipidemia in adult male offspring of DOSS treated C57BL/6 dams

How to implement deprescribing into clinical practice

Evaluation of Deprescribing Amiodarone After New-Onset Atrial Fibrillation in Critical Illness

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