⚡ Promptolis Original · Healthcare & Medical
💊 Medication Questions + Safety Tracker
Medication review framework grounded in Beers Criteria, STOPP/START (polypharmacy), FDA interaction guidelines, pharmacy-led MTM programs — complete list + interactions + age-specific + pharmacist consultation + emergency signs.
Why this is epic
Medication errors are the leading preventable harm in healthcare — 1 in 5 Medicare beneficiaries experience medication-related harm annually (AHRQ). This tracker prevents the common errors: missed interactions, age-inappropriate medications, polypharmacy issues, adherence gaps.
Framework grounded in Beers Criteria (potentially inappropriate meds for 65+), STOPP/START (polypharmacy review), FDA interaction guidelines, and pharmacy-led Medication Therapy Management programs. Specifically designed for interaction checking + appointment prep.
Includes pharmacist consultation script (pharmacists provide free 10-15 min consultations, undervalued resource), age-specific considerations (Beers 65+, pediatric dosing, pregnancy/lactation), and emergency signs for specific medication categories (SSRIs, ACE inhibitors, metformin).
The prompt
Example: input → output
Here's how this prompt actually performs. Real input below, real output from Claude Opus 4.
Medication list: - Metformin 1000mg BID (Type 2 diabetes) - Atorvastatin 20mg daily (cholesterol) - Lisinopril 10mg daily (blood pressure) - Sertraline 50mg daily (anxiety, started 3 months ago) - Omeprazole 20mg daily (GERD, taking 4+ years) OTC + supplements: - Fish oil 1000mg daily - Vitamin D3 2000 IU daily - Magnesium 400mg at bedtime - Occasional ibuprofen for headaches Age: 58 Conditions: Type 2 diabetes, hypertension, hyperlipidemia, anxiety, GERD Recent changes: Sertraline started 3 months ago (for anxiety) Concerns: Dry mouth worsening, occasional feeling dizzy when standing, unsure if medications optimized Appointment type: Annual medication review with PCP
Your Medication Review — Comprehensive Annual Check
Complete Medication Summary
| Medication | Dose | Frequency | For What | Duration |
|---|---|---|---|---|
| Metformin | 1000mg | 2x daily | Type 2 diabetes | Ongoing |
| Atorvastatin | 20mg | Once daily | Cholesterol | Ongoing |
| Lisinopril | 10mg | Once daily | Blood pressure | Ongoing |
| Sertraline (Zoloft) | 50mg | Once daily | Anxiety | 3 months |
| Omeprazole | 20mg | Once daily | GERD | 4+ years |
| Fish oil | 1000mg | Once daily | General cardiovascular | Ongoing |
| Vitamin D3 | 2000 IU | Once daily | General health | Ongoing |
| Magnesium | 400mg | At bedtime | Sleep / general | Ongoing |
| Ibuprofen (OTC) | Varies | As needed | Headaches | Occasional |
Total: 9 medications + supplements. You're in mild polypharmacy territory (5+ medications). Annual review is appropriate and valuable.
Questions for Each Medication
Core Questions for PCP
1. Sertraline (3 months in): Is 50mg the right target dose? Many people need 100-150mg for full effect. Often doctors start at 50 and don't titrate up to optimal. Ask: 'Is my current anxiety response at the level we're targeting, or would a dose increase help?'
2. Omeprazole (4+ years): Long-term PPI use (>1 year) has associations with: B12 deficiency, bone density issues, kidney concerns. Ask: 'Am I still needing daily PPI? Could we try stepping down to H2 blocker (like famotidine) or as-needed dosing?' FDA recommends re-evaluating long-term PPI annually.
3. Lisinopril + anxiety meds: Check blood pressure consistently. Anxiety can elevate BP; sometimes anxiety treatment reduces BP medication need over time.
4. Metformin optimization: Given you also have anxiety + GERD, and A1C status would inform, is current dose optimal? Any barriers to adherence?
5. Ibuprofen 'occasional': With lisinopril + metformin, ibuprofen should be minimal. NSAIDs + ACE inhibitors can cause kidney issues; NSAIDs + diabetes can affect kidney function. Ask: 'Can I use acetaminophen instead for most headaches?'
Potential Interactions + Red Flags
Important Interactions in Your Regimen
1. Sertraline + Ibuprofen: Both can increase bleeding risk, especially in combination. Significant caution; use acetaminophen for headaches instead when possible.
2. Lisinopril + Ibuprofen: NSAIDs can reduce ACE inhibitor effectiveness + cause kidney stress. Minimize NSAID use.
3. Sertraline + Magnesium: Generally safe, no significant interaction. Continue if helpful for sleep.
4. Omeprazole + Vitamin D / Fish oil: Long-term PPI can reduce calcium + magnesium absorption. Your magnesium supplementation may partially compensate.
5. Metformin + Vitamin B12: Long-term metformin depletes B12 in 10-30% of users. Ask PCP to check B12 level if not tested in past year. B12 deficiency can mimic depression/anxiety symptoms.
Explaining Your Symptoms
Dry mouth worsening: Sertraline commonly causes dry mouth. Also metformin + lisinopril can contribute. Usually improves over months; sugar-free gum, adequate water help. Not typically dose-reduction territory unless severe.
Occasional dizziness when standing (orthostatic hypotension): Lisinopril effect + possibly sertraline early weeks. If it's resolved within 1-2 minutes, manageable. If prolonged, severe, or frequent, dose adjustment warranted. Tell PCP.
Age-Specific Considerations (58, so not yet 65+ Beers)
You're approaching the Beers Criteria age (65+). At 65:
- Diphenhydramine (Benadryl) for sleep — avoid (increased falls, cognitive effects)
- Benzodiazepines (Xanax, Ativan) — very limited use, short-term only
- PPIs (your omeprazole) — time-limited use ideal, already relevant now
- Anticholinergics — avoid when possible
Early consideration for you: Omeprazole long-term use — start planning step-down now rather than at 65.
Pharmacist Consultation Script (before PCP visit)
Call your pharmacy, ask to speak to pharmacist (not just tech):
'Hi, I'm [name], I take [list all medications]. I'm having my annual medication review with my PCP next week. Before the visit, could you run a comprehensive interaction check on my full medication list including OTC and supplements? Specifically, I'm noticing [dry mouth, dizziness], and I'd like to understand if any of these medications might be contributing. Also, I've been on omeprazole for 4 years — is that still appropriate given the long-term PPI concerns I've read about?'
Pharmacists LOVE this kind of engagement. Most provide 10-15 minutes of free consultation + print out an interaction report you can bring to your doctor.
What to Monitor
Weekly self-check (5 minutes)
- Any new side effects?
- Medications taken consistently? (If >2 missed doses in a week, adherence issue to address)
- Blood pressure (if home monitor): trending?
- Blood glucose (for diabetes): patterns?
Monthly labs conversation with PCP
- Annually minimum: CBC, CMP, A1C, lipid panel, B12 (on metformin), vitamin D
- Your diabetes + HTN warrant every 3-6 months: A1C, BP, kidney function (BUN/creatinine)
- Your long-term PPI warrants: magnesium, B12, bone density (DEXA) every 2-3 years
Annual comprehensive
- This review (which you're doing)
- All labs current
- Medication list updated
- Any specialist opinions (endocrinology for diabetes if A1C not at goal)
Emergency Signs (Call 911 / Go to ER)
Sertraline-specific emergencies
- Serotonin syndrome signs (agitation, rapid heartbeat, muscle rigidity, high fever) — life-threatening, ER immediately
- Severe GI bleeding (black stool, vomiting blood)
- Suicidal thoughts — reach out to prescriber same-day; if immediate danger, 988 Suicide & Crisis Lifeline
Metformin
- Lactic acidosis signs (severe abdominal pain, unusual fatigue, muscle pain, difficulty breathing) — rare but serious, ER
Lisinopril
- Angioedema (swelling of lips, tongue, throat) — can be fatal, ER immediately + discontinue
- Severe dizziness / fainting
General
- Allergic reactions: hives, difficulty breathing, swelling
- Severe changes in heart rhythm: palpitations, chest pain
- Unusual bruising or bleeding (new)
Key Takeaways
- 9 medications total — mild polypharmacy. Annual review valuable; consider Medicare Part D MTM if eligible.
- Sertraline 3 months: may need dose titration up (50mg → 100-150mg if not fully responsive).
- Omeprazole 4+ years: time to re-evaluate step-down or as-needed dosing.
- B12 level check: long-term metformin depletes B12 in 10-30%. Request lab.
- Minimize ibuprofen (interacts with lisinopril + sertraline). Acetaminophen when possible.
- Call pharmacist before PCP visit for free interaction check — valuable prep.
- Dry mouth + orthostatic dizziness: normal but watch — mention to PCP.
- Emergency signs to know: serotonin syndrome, angioedema, lactic acidosis, suicidal thoughts.
- Approaching 65: Beers Criteria will apply. Plan PPI step-down now.
NOT MEDICAL ADVICE. Medication decisions belong with prescribing physician + pharmacist. For emergency reactions, 911 or Poison Control 1-800-222-1222.
Common use cases
- Patients on 5+ medications needing annual review
- Recently prescribed new medication with questions about interactions
- Adults approaching or past 65 needing Beers Criteria review
- Patients experiencing side effects unsure if medication-related
- Caregivers managing elderly parent's medication regimen
- Parents of children on chronic medications needing dosing clarity
- Patients preparing for pharmacist or PCP appointment
- Anyone adding OTC / supplements to prescription regimen
- Patients with chronic conditions on multiple specialty medications
- Anyone experiencing concerning symptoms possibly medication-related
Best AI model for this
Claude Opus 4 or GPT-5 Thinking for complex polypharmacy review (5+ meds). Any LLM for basic single-medication questions.
Pro tips
- Complete medication list to EVERY appointment: prescription + OTC + supplements + herbs. Many interactions missed from OTC.
- Pharmacists are medication specialists. Free 10-15 min consultation. Undervalued resource.
- Understand EACH medication's why. 'Why am I taking this?' If you don't know, adherence likely to suffer.
- Know 'what to watch for' per medication. Serious side effects + timing (first 2 weeks critical).
- Drug-food interactions: Warfarin + greens, grapefruit + statins/CCBs. Take at specific times.
- Beers Criteria for 65+. Certain medications potentially inappropriate in older adults. Review annually.
- Polypharmacy (5+ meds) warrants Medicare Part D MTM review annually — free.
- Supplements DO interact with medications. St. John's Wort, fish oil, turmeric, many others.
- Verify pill + dosage at pharmacy pickup. Errors happen.
- Generic vs brand 85-90% equivalent. Exception: thyroid, seizure, blood thinner (narrow therapeutic windows).
Customization tips
- For ELDERLY (65+) with polypharmacy (5+ meds), request Medicare Part D Medication Therapy Management (MTM) review — FREE + comprehensive. Beers Criteria review essential; many medications that are fine for younger adults are potentially inappropriate in older adults.
- For MENTAL HEALTH MEDICATIONS specifically, questions shift: therapeutic response timing (SSRIs take 4-8 weeks for full effect), sexual side effects (common, rarely discussed by patients), discontinuation risks (never stop SSRI abruptly). Psychiatric pharmacist consultation if available.
- For CANCER MEDICATIONS (chemotherapy, targeted therapy, hormone therapy), entirely different framework. Oncology pharmacist consultation + specific cancer center for questions. Many have patient navigators specifically for medication management.
- For BLOOD THINNERS (warfarin, DOACs like Eliquis/Xarelto), interaction watch is intense. Warfarin requires regular INR monitoring + vitamin K food consistency. DOACs easier but still major interactions (NSAIDs, certain antibiotics, antifungals).
- For THYROID MEDICATIONS, timing matters significantly. Levothyroxine: same time daily, empty stomach, wait 30-60 min before food. Interaction with calcium, iron, PPIs reduces absorption.
- For DIABETES MEDICATIONS specifically, hypoglycemia awareness + recognition critical. Signs: shaky, sweaty, confused, heart racing. Fast-acting sugar (juice, glucose tablets) resolves. Severe hypoglycemia (<54 mg/dL) is emergency.
- For PAIN MEDICATIONS (especially opioids), tolerance + dependence real concerns. Specific questions: alternatives tried, tapering plan, non-opioid options (gabapentin, duloxetine for neuropathic pain), naloxone availability for accidental overdose.
- For PREGNANCY + BREASTFEEDING, medication safety entirely different. Specific medications safe, others contraindicated. Mother Risk + LactMed are authoritative databases. OB-GYN + pediatrician coordination essential.
- For KIDS' MEDICATIONS, weight-based dosing matters. Ask pharmacist to double-check dose. Flavoring options for liquids. Adherence strategies age-appropriate (stickers, charts, etc.).
- For TRAVEL / GOING ABROAD, get 30-60 day supply in labeled containers, carry copy of prescriptions, know generic names (international), research destination-country availability. Controlled substances especially require planning.
Variants
Standard Adult Review
5+ medications, annual review framework
Elderly 65+ (Beers Criteria)
Age-specific inappropriate medication review
Pediatric Medication Review
Weight-based dosing, age-appropriate formulations
Mental Health Medications
SSRI/SNRI, benzodiazepines, mood stabilizers, titration + discontinuation
Blood Thinners
Warfarin INR monitoring, DOAC interactions, bleeding risk
Diabetes Medications
Hypoglycemia awareness, insulin, GLP-1 agonists, timing
Pain Medications
Opioid alternatives, multi-modal approach, naloxone access
Frequently asked questions
How do I use the Medication Questions + Safety Tracker prompt?
Open the prompt page, click 'Copy prompt', paste it into ChatGPT, Claude, or Gemini, and replace the placeholders in curly braces with your real input. The prompt is also launchable directly in each model with one click.
Which AI model works best with Medication Questions + Safety Tracker?
Claude Opus 4 or GPT-5 Thinking for complex polypharmacy review (5+ meds). Any LLM for basic single-medication questions.
Can I customize the Medication Questions + Safety Tracker prompt for my use case?
Yes — every Promptolis Original is designed to be customized. Key levers: Complete medication list to EVERY appointment: prescription + OTC + supplements + herbs. Many interactions missed from OTC.; Pharmacists are medication specialists. Free 10-15 min consultation. Undervalued resource.
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