Adverse Drug Effects In The Elderly

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Contents 1 More Specific Terms 2 Epidemiology 3 More General Terms 4 Additional Terms 5 References

More Specific Terms

• drugs commonly producing delirium
• pharmaceutical agents associated with constipation
• risk factors for falls

Epidemiology

• 1/3 of hospitatilizations in elderly (includes non-compliance)

• 11% due to non-compliance
• 17% due to drug adverse effect

• most commonly dermatologic, gastrointestinal, neurologic
• 1/3 due to allergies, 1/3 due to unintentional overdoses
• most common culprits

• hypoglycemic agents, opioids, anticoagulants, digoxin, amoxicillin, antihistamines, antiplatelet agents, phenytoin
• most commly implicated medications [3]

• warfarin, insulin, aspirin, clopidogrel, digoxin

• 1/3 due to warfarin, insulin, or digoxin

• ambulatory elderly on average of 4.5 meds
• institutionalized elderly on average of 7 meds
• high-risk prescribing practices common [4]

• # only digoxin in Beer's criteria

More General Terms

• geriatrics
• drug adverse effect(s)

Additional Terms

• Beers criteria
• pharmacokinetics in the elderly
• polypharmacy (unecessary drug prescription)

References

1. Prescriber's Letter 13(12): 2006 Emergency Department Visit Due to Adverse Drug Events Detail-Document#: [1] (subscription needed) [2]
2. Zhan C, Sangl J, Bierman AS, Miller MR, Friedman B, Wickizer SW, Meyer GS. Potentially inappropriate medication use in the community- dwelling elderly: findings from the 1996 Medical Expenditure Panel Survey. JAMA. 2001 Dec 12;286(22):2823-9. PMID: [3]
3. Budnitz DS et al, National surveillance of emergency department visits for outpatient adverse drug events. JAMA 2006, 296:1858 PMID: [4]
   - Budnitz DS et al, Medication use leading to emergency department visits for adverse drug events in older adults. Ann Intern Med 2007, 147:755 PMID: [5]
4. Guthrie B et al. High risk prescribing in primary care patients particularly vulnerable to adverse drug events: Cross sectional population database analysis in Scottish general practice. BMJ 2011 Jun 21; 342:d3514 PMID: [6]

adverse drug effects in the elderly