Misc Family member is on a lot of different medications, how will these effect him?

[Combine12]

So, my father had a bad accident while working for the Royal Australian Air Force and it badly affected his knees... to the point that he will need both knees replaced, but he can't get them done right away because he is too young and needs to wait into his sixties before it can be done (about a decade in other words.) so the doctors prescribed him Fentanyl 25mg patches... which was two years ago and now every time we visit a doctor to ask about his health he gets given more drugs.

This is what he is currently on;

Fentanyl patches - 75mg (the patch is replaced every 2-3 days.)
Jurnista - 8mg/16/mg/32mg
Palexia - 50mg/150mg
Andepra - 60mg
Imrest - 7.5mg
Avanza - 3mg
Alepam - 30mg
Paxam - 500mg
Lyrica - 300mg
Naproxen - 1000mg
Tramadol SR - 100mg

The doctor that my father is seeing has tried taking him off the Fentanyl and onto other painkillers, these have always had really bad reactions (hallucinations, pain and vomiting.) almost a hour or two after taking them.

OK, what i want to know is 1) what is most of this stuff? 2) What will this stuff be doing to him, internally as well as mentally/emotionally? 3) can he actually get off this stuff when the time comes for him to get the knee replacements?

Thanks for your help, if you need me to elaborate or anything, please ask.

 

[pinpoint]

It would help significantly if you didn't use brand names since they vary from country to country. Anyways half of those drugs are strong opioids fent, morphine, hydromorphone, etc. with benzos & an SNRI. It seems like a lot of drugs with overlapping effects, but then again, we are not doctors here. Whether he can get off depends on his desire to do so, however he will most definitely experience significant withdrawal.

 

[Papaverium]

From my knowledge, Fentanyl, Jurnista, Palexa, and Tramadol are all opiate receptor agonists, so they would intensify eachothers' effects, which can cause nausea.

Duloxetine is a serotonin-norepinephrine reuptake inhibitor. It possesses antidepressant/anti-anxiety properties.

Imrest is Zopiclone, a hypnotic class drug, and when taken in larger doses can cause delirious hallucinations in the user.

Avanza is a tetracyclic antidepressant, so similar to Duloxetine.

Alepam is in the benzodiazepine class, which would increase the effects of the opiates, and the Imrest.

Paxam is clonazepam, another benzodiazepine. This class of drug is a sedative. and a regular dose would be around 1-2 mgs, not 500mgs

Lyrica is an anticonvusant medication. Used for seizures.

Naproxen is an anti-inflammatory like a strong version of Ibuprofen (Advil), but if taken tooo much on an everyday basis it can cause stomach problems leading to ulcers.

My educated guess is that the antidepressants reacting with the Imrest may cause hallucinations. And that doctor has him on alllllot of opiate medications, which can be dangerous mixed with benzodiazepines.

~Verri

 

[Combine12]

It would help significantly if you didn't use brand names since they vary from country to country. Anyways half of those drugs are strong opioids fent, morphine, hydromorphone, etc. with benzos & an SNRI. It seems like a lot of drugs with overlapping effects, but then again, we are not doctors here. Whether he can get off depends on his desire to do so, however he will most definitely experience significant withdrawal.

Really sorry about using the brand names, i didn't know that the names changed per country and I've never had a great deal of experience with this type of stuff before... uh, how bad would the Withdrawals and the after effects be? as bad as getting off Heroin or not as hard?

From my knowledge, Fentanyl, Jurnista, Palexa, and Tramadol are all opiate receptor agonists, so they would intensify eachothers' effects, which can cause nausea.

Duloxetine is a serotonin-norepinephrine reuptake inhibitor. It possesses antidepressant/anti-anxiety properties.

Imrest is Zopiclone, a hypnotic class drug, and when taken in larger doses can cause delirious hallucinations in the user.

Avanza is a tetracyclic antidepressant, so similar to Duloxetine.

Alepam is in the benzodiazepine class, which would increase the effects of the opiates, and the Imrest.

Paxam is clonazepam, another benzodiazepine. This class of drug is a sedative. and a regular dose would be around 1-2 mgs, not 500mgs

Lyrica is an anticonvusant medication. Used for seizures.

Naproxen is an anti-inflammatory like a strong version of Ibuprofen (Advil), but if taken tooo much on an everyday basis it can cause stomach problems leading to ulcers.

My educated guess is that the antidepressants reacting with the Imrest may cause hallucinations. And that doctor has him on alllllot of opiate medications, which can be dangerous mixed with benzodiazepines.

~Verri

christ, Is that as bad as i think it is?

 

[pinpoint]

Considering benzodiazepines, opioids, SSRI's & lyrica are frequently cited as having the 'worst withdrawal syndrome ever' I'd imagine trying to come off all of these is going to be tough, but he might be looking at being on some form of opioid-drug for long-term.

 

[Papaverium]

Well if he's been using them for a long period of time, he would have to taper off, because Opiates and Benzos are highly addictive there would be some withdrawal effects. As far as the hallucinations go, I don't really see opiates causing that, Ive had my share of opiates to know this, but Zopiclone, or Imrest as you called it, can cause hallucinatory effects if taken in high doses. But if he takes it as prescribed, there's most likely some kind of cross-psychoactivity with the antidepressant medication. Also, opiates and benzos when taken together are not really dangerous if taken as prescribed. I don't like Naproxen, if you take it on a regular basis, it can start to hurt your stomach.

~Verri

 

[Keif' Richards]

That is a hefty cocktail of prescription medications.

Multiple Strong/Weak Opioids, Benzodiazepines, a Z-Drug and the Lyrica (pregabalin) make for a tough road ahead.

All of these drugs can be sedating in their own right, but in combinations like the ones you are describing, the sum is worth more than the parts. They are all hard to withdraw from. Opioid withdrawal is very uncomfortable, but not lethal if the patient is in reasonable health. Benzodiazepines, however, can be deadly to withdraw from.

It would be a long road to regain complete homeostasis, but if done properly, the patient could be okay in a year's time. It sounds like quitting the opiods aren't even an option at this point, as he has more major surgery coming up.

Is he regularly sedated/drowsy during the day, or do you find he is usually awake and alert? If you find that he is consistently drowsy/tired/incoherent, that might be a good indicator that he is overmedicated and could cut back on a couple of things. This is just my thoughts on the matter, I'm not a doctor and this is not medical advice, but in my opinion, the current drug cocktail is a little on the strong side.