Geriatric polypharmacy, the concurrent use of multiple medications in older adults poses significant risks in radiologic settings, where contrast agents, sedation protocols, and procedural preparation intersect with complex pharmacologic profiles. This manuscript explores the clinical implications of polypharmacy in radiology nursing, emphasizing the role of nurses in identifying potentially inappropriate medications, preventing adverse drug events, and promoting a safer imaging experience for geriatric patients. Drawing on recent literature and clinical practice guidelines, the paper highlights evidence-based tools such as the American Geriatrics Society Beers Criteria, the Screening Tool of Older Persons' Prescriptions (STOPP), and the Screening Tool to Alert to Right Treatment (START) protocols and presents a Clinical Nurse Specialist-led deprescribing model tailored for acute care environments. Case examples illustrate how radiology nurses can intervene during preprocedure screening, medication reconciliation, and interdisciplinary communication. The manuscript also outlines practical recommendations for radiology departments, including staff education, policy development, and patient-centered strategies to reduce medication-related harm. Unique radiology-specific considerations such as contrast media interactions, sedation risks, and nuclear medicine procedures are highlighted to underscore the specialty's distinct challenges. As the aging population grows and imaging demands increase, radiology nurses must be equipped to navigate the complexities of geriatric pharmacology. This paper calls for expanded nursing leadership in medication safety and advocates for scalable interventions that embed polypharmacy awareness into radiologic workflows. By elevating the role of radiology nurses in geriatric care, we can improve outcomes, reduce risks, and advance the quality of imaging services for older adults.
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