ABSTRACT
Angioedema is a serious adverse event that can manifest as lower extremity edema, face swelling, rash, hives, and a swollen tongue, which can sometimes lead to airway constriction and death. It is a well-documented reaction within the angiotensin-converting enzyme inhibitor drug class, where the bradykinin pathway leads to angioedema. We report a case where a patient experienced angioedema after taking venlafaxine. We evaluated other antidepressants as potential treatment options for the patient. We further examined potential cross-reactivity between antidepressants in order to find alternative medications for patients that experience serious adverse effects.
ABSTRACT
OBJECTIVE: To review the safety and efficacy of cannabis use for chronic pain in older people.
SETTING: The case took place in a geriatric primarycare clinic in Colorado.
PRACTICE DESCRIPTION: The clinic serves adults 75 years of age and older where clinical pharmacists are used for medication consults and follow-up.
PRACTICE INNOVATION: Older people are using cannabis to treat a variety of conditions, with use increasing as more states legalize cannabis medically and recreationally. The primary reason for use is pain. Pharmacists in Colorado can assist with education regarding cannabis use and evaluate if cannabis may be safe for older people.
MAIN OUTCOME MEASUREMENT: This case evaluates the use of a combination CBD:THC cannabis product in a 78-year-old female patient who was previously using opioids for degenerative disc disease and osteoarthritis.
RESULTS: The patient found improvement in her pain when using the combination cannabis product without any adverse effects.
CONCLUSION: Further safety and efficacy evidence is needed for using combination cannabis products for pain management in older people.
