M1, here's the list

Ed1937

Unless otherwise noted, it is once a day/evening:

Amlodipine 5 mg

Atorvastatin 80 mg

Losartan 25 mg

Metopolol tartrate 50 mg 2X daily

Areds2 2X daily

Rivastigmine patch 4.6 mg

Seroquel 12 1/2 mg

Warfarin 2 1/2 mg

B12 1000 mg

She has been pretty fatigued, and I was considering stopping the patch. Fatigue is one of the side effects, and I think that adds to the possibility of falling. The pharmacist thought it was a good idea to keep the Seroquel for a short time, then maybe discontinue it.

jfkoc

Also a good site to check  interactions is drugs.com.

Ed1937

Yes, I use  that site.

Quilting brings calm

We dropped the patch for mom earlier this year as her Part D plan would not pay for it for 2022. It didn’t seem to make a  difference for her memory anyway.  Although I think the patch is supposed to help some psychological issues in addition to the memory.  I did notice an increase in anxiety since then, but there’s a lot of drama in mom’s life so it’s very difficult to tie anxiety to dropping the  patch. 

Your wife is far enough along that the patch is  probably no longer useful for memory and confusion, but you might ask the doctor about whether or not it helps the seroquel work.  

M1

That's not too bad of a list Ed.  No huge red flags.  The questions that come to my mind:  first, I would agree with you, the rivastigmine may not be doing much cognitively at this point, and it may be worth discontinuing for simplicity's sake.  Ditto with the B12--not likely to hurt much, but not likely to help either (true B12 deficiency usually has to be treated with injections).  

The warfarin we've talked about elsewhere, and you may have to continue to revisit that one, especially if she has more falls, or if other medications get started:  lots and lots of medications interact with warfarin as I'm sure you know.

I think you could also argue that with advanced dementia, the atorvastatin may not be very useful at this stage--but that depends on any previous history of heart attack or stroke.  If she tolerates it without side effects, you can leave well enough alone.  I assume the lisinopril, metoprolol, and amlodipine are for blood pressure and her atrial fib (the metoprolol especially there controls heart rate).

And I think the Seroquel is totally a judgement call.  If it helps her sleep, it might be worth continuing.  I'll be interested to see if they get back to you about why you weren't consulted on it.  

Hope that helps.....

Ed1937

Thank you very much, M1 and Quilting! It looks as though cutting the Seroquel in half might have been a good thing. I just talked to a nurse. She told me she could see her, at that time, walking the halls with a walker, and she was doing great with it. This was surprising because she had a hard time using a walker at home. It was like she couldn't get her hands and feet to work together. So that was a very welcome surprise. And the fact that she is leaving her room is also a good sign, and not expected.

She did not have a full blown stroke, but she had several TIAs in the past. So maybe I'll just leave that one alone. M1, I really appreciate the fact that you took the time to look this over for me, and giving me your thoughts about it. I feel better.

jmlarue

I recently discovered that discontinuing Losartan resolved the issues I was having with joint pain, muscle weakness, and leg cramps. I had been referred to Orthopedics to see if the increased pain and weakness was attributable to my degenerating hips. They couldn't see any major changes on the x-rays signaling it was time for surgery. Maybe it's just coincidence, but about a weak after stopping the Losartan, my pain level dropped significantly and my I've seen improvement in my gait, balance, and ability to walk across the house without feeling utterly exhausted.

My DH suffered similar side effects from statin drugs (he tried several). He had both leg pain and fairly severe muscle weakness. He had several falls because of that. Taking CoQ-10, recommended by his doctor, did nothing to relieve the problems. Following an incident where he was not able to stand from sitting at the dining table and not being able to walk without weight-bearing assistance, I chose to discontinue the statins (against doctor's advice). Again, it took about a week to see the leg pain mostly resolve. Muscle strength improved over several months. Some muscle weakness remains, but has improved so that he can stand and walk unassisted around the house again.

Your DW's mileage might vary. For me (and as the POA for my DH's healthcare decisions), I am increasingly reluctant to agree to adding or continuing a drug based on the vague assertions that it "may" be beneficial in spite of the very real side effects.

Ed1937

I hear you, jm. Thanks for the post.