Drug-Drug Interactions in a Geriatric Outpatient Cohort

Abstract

In this study, nearly half of the geriatric outpatients attending a diagnostic day clinic who were taking more than one drug were candidates for DDIs. One-quarter of these patients were found to have possible adverse events or diminished treatment effectiveness that may have been at least partly caused by these DDIs. These potential interactions can be identified through clinical evaluation. In the majority of patients (99 of 172) the potential interactions resulting in possible ADRs or diminished effectiveness were not present in the 'Top Ten' interactions described by a national database of public pharmacies, a finding that emphasizes that the particular characteristics of geriatric patients (e.g. frequent psychiatric co-morbidities) need to be considered when evaluating their drug use. At least 7% of all patients taking more than one drug, and 80% of those with possible drug interactions whose drug regimen was adjusted, benefited from changes made to their drug regimens.

Interações medicamentosas potenciais entre idosos em uso dos anti-hipertensivos da Relação Nacional de Medicamentos Essenciais do Ministério da Saúde do Brasil

“…Em outras avaliações de população idosa 8,11,16 , essa classe de medicamentos também aparece no topo das listas de IMP mais frequentes. No entanto, em amostra que inclui adultos jovens 14,17 , a digoxina e os diuréticos figuram entre as interações mais frequentes, deixando os inibidores da enzima conversora de angiotensina em posições inferiores.…”

Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

“…In literature, the prevalence of potential DDIs in community-dwelling older adults ranges from 4% to 46% (22)(23)(24)(25)(26). It is important to note that we screened for potential DDIs using DDI software, without knowing whether the interaction actually resulted in an adverse effect for the patient.…”

Pharmacotherapy for Chronic Low Back Pain

“…NSAIDs have been associated with potentially clinically meaningful increases in blood pressure (Forman et al, 2005;Johnson et al, 1994;Pavlicevic et al, 2008), probably both through direct effects (Forman et al, 2005;Johnson et al, 1994) and adverse pharmacokinetic interactions with diuretics and angiotensin-converting enzyme inhibitors (Pavlicevic et al, 2008). Drug interactions of NSAIDs with antihypertensives (angiotensin-converting enzyme inhibitors, diuretics), selective serotonin reuptake inhibitors (SSRIs), and corticosteroids (American Geriatrics Society, 2009;Malhotra et al, 2001;Tulner et al, 2008) are common. Ibuprofen can nullify the cardioprotective effects of aspirin (Gengo et al, 2008).…”