Adverse Drug Reactions in the Elderly

Can We Stem the Tide?

Shari J. Lynn

Disclosures

Am Nurs Journal. 2012;7(1)

Drug Interactions: Pharmacokinetic vs Pharmacodynamic

Drug interactions can be pharmacokinetic or pharmacodynamic.

With a pharmacokinetic interaction, one drug affects the other's absorption, distribution, metabolism, or excretion. An example occurs when a patient takes the antibiotic ciprofloxacin with olanzapine, a drug used to treat schizophrenia. Ciprofloxacin blocks the enzyme that breaks down olanzapine; this results in high blood levels of olanzapine, which in turn may cause muscle spasms and predispose the patient to falls.
In a pharmacodynamic interaction, two drugs have additive or antagonistic effects. For example, if ciprofloxacin is given with glibenclamide (an antidiabetic), it may increase the antidiabetic effects of glibenclamide, possibly causing profound hypoglycemia.

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Abstract and Introduction
Incidence of ADRs
Defining and Classifying ADRs
Polypharmacy and Drug Interactions
Drug Interactions: Pharmacokinetic vs Pharmacodynamic
Beers Criteria
Know Your Professional Responsibility
Obtaining Medication History From an Older Adult
References

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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