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Comment & Response
October 2017

β-Blockers and Diltiazem Combination—Bear in Mind the Risk of Heart Block

Author Affiliations
  • 1Institute of Clinical Pharmacology, Santa Maria della Misericordia University Hospital, ASUIUD, Udine, Italy
  • 2Department of Medicine, University of Udine, Udine, Italy
JAMA Intern Med. 2017;177(10):1543-1544. doi:10.1001/jamainternmed.2017.4765

To the Editor I read with interest the Teachable Moment by Carroll and Hassanin1 published in a recent issue of JAMA Internal Medicine and concerning the worrisome issue of polypharmacy in the elderly. I fully agree with Carroll and Hassanin1 about the opportunity of considering medication reconciliation and of containing the number of comedications in the elderly to a minimum. The strategies proposed by Carroll and Hassanin1 (ie, use of established prescribing tools such as Beers criteria and STOPP criteria and/or discontinuation of medications without a clear indication) are robust and may surely concur in reducing polypharmacy. Likewise, they may be helpful in effectively preventing avoidable drug-drug interactions leading to unintentional hospital admission.

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