Prescribing Cascades and Polypharmacy in Older Adults

A review identified 24 potentially harmful prescribing cascades involving common medicines, including NSAID-related blood-pressure worsening that can prompt unnecessary antihypertensive escalation. Medication reconciliation, OTC-drug review, pharmacist involvement, and better decision support may reduce avoidable treatment, adverse effects, and costs. Ketamine's limited, specialist role in chronic pain reinforces the need for evidence-based prescribing and monitoring.