Adverse Drug Reactions in the Elderly

Can We Stem the Tide?

Shari J. Lynn

Am Nurs Journal. 2012;7(1)

Abstract and Introduction

Introduction

With age comes the prospect of multiple health problems that require treatment with multiple medications. The likelihood of coronary artery disease, arthritis, stroke, diabetes, cancer, and hypertension increases with age, and along with them comes the need for multiple drug therapies. Also, many elderly people take over-the-counter (OTC) medications, vitamins, and herbal supplements.

When caring for an older adult taking multiple medications, keep in mind that:

concurrent use of multiple medications increases the potential for adverse drug reactions (ADRs) and drug interactions
age-related pharmacokinetic changes can alter drug absorption, distribution, metabolism, and excretion; for example, many elderly patients have renal impairment, which affects drug absorption and excretion and can alter blood drug levels
age-related changes in pharmacodynamics can alter a drug's effects
compliance with medication regimens may decrease in elderly patients, who may have difficulty keeping track of multiple medication schedules
patients may be treated by multiple physicians, who may be prescribing drugs without knowledge of other medications the patient is taking.

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Defining terms
An unexpected adverse reaction is a reaction whose nature or severity isn't consistent with the drug's current labeling. A side effect is an unintended effect that occurs at normal drug dosages and relates to the drug's properties. An adverse event or experience is a medical occurrence that may arise during treatment but doesn't have a causal relationship with the drug in question. A serious adverse event is a fatal, life-threatening, or permanently disabling event that requires extensive hospitalization, leads to a congenital anomaly, or requires an intervention to avert permanent impairment or damage. A signal is an observed possible adverse event that is unknown or wasn't previously documented.

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Adverse Drug Reactions in the Elderly

Can We Stem the Tide?

Abstract and Introduction

Introduction

Tables

References

Authors and Disclosures

Authors and Disclosures

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