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Discussion with the patient and consideration of overall quality of life is essential.

The selection of appropriate pharmacotherapy for elderly patients is a challenging and complex process, even when cancer is not involved, and although a framework for incorporation of drug discontinuation into the prescribing process has been proposed, it is not yet standard practice.

There is presently no consensus among oncologists or specific guidelines for management or reduction of polypharmacy in older people with cancer who have treatment in the ambulatory setting.

Steps in the medication discontinuation process include proper planning, communication with the patients (and family or carer) and other clinicians, and monitoring of the patient for beneficial or harmful effects.

Histamine is a chemical that is responsible for many of the signs and symptoms of allergic reactions, for example, swelling of the lining of the nose, sneezing, and itchy eyes.

Two types of OTC antihistamines are available: first-generation and second-generation. First-generation antihistamines are sometimes used in OTC . Antihistamines prevent histamines from attaching to your cells and causing symptoms.

Unlike the first generation antihistamines, cetirizine and other second-generation antihistamines do not readily enter the brain from the blood, and, therefore, they cause less drowsiness.

Cetirizine may cause more drowsiness than other second generation antihistamines. Theophylline (Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin)reduces the breakdown of cetirizine by 16% and can increase blood levels of cetirizine.

Recognition of polypharmacy is the first step towards prevention.

Rational discontinuation of drugs in older adults is a logical component in the management of polypharmacy, and is recommended as part of a comprehensive geriatric assessment in such patients with cancer.

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