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Possible Consequences of Drug Therapy Discontinuation

Description

Drug therapy may be discontinued for a number of reasons. The impact may be minimal for a person taking a single drug for a single reason that has resolved. The impact may be significant for a person taking multiple medications for conditions that are still active.


 

A common clinical scenario is a patient taking multiple medications with a suspected drug reaction for which no single drug has been implicated. A practice is to discontinue "nonessential" drugs and then to add back drugs if needed. Deciding which drugs are essential and which are not may not always be obvious.

 

Type of Medication

Consequence of Discontinuation

analgesic

pain

antiarrhythmic

cardiac arrhythmia

antibiotics

recurrent infection

anticoagulant

thrombosis, embolism, stroke, AMI

antidepressants

depression

antiepileptic agents

seizure

antihypertensive

hypertension

anti-inflammatory or antipyretic agent

recurrence of inflammation and fever

diuretic

fluid retention

drug with risk of dependency

withdrawal reaction

immunosuppressant

immune reconstitution

insulin

hyperglycemia

oral contraceptive

pregnancy

thyroxine or other hormone

hypothyroidism or hormone deficiency

 

If a discontinued drug has induced metabolism of a continued drug, then the dose of the continued drug may need to be increased.

 

If a discontinued drug has depressed metabolism of a continued drug, then the dose of the continued drug may need to be decreased.

 

On the other hand, discontinuing a drug whose side effects has resulted in addition of other drugs may reduce the overall burden on the patient.

 


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