The Elderly and Drug Interactions

Lamy, Peter P.

doi:10.1111/j.1532-5415.1986.tb05764.x

Cited by 39 publications

(14 citation statements)

References 47 publications

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“…This elderly sub-group, commonly referred to as the 'old old', is recognized as having the highest risk of both illness and adverse drug reactions. 19 Also, the period offollowup for this elderly population was 18 monthsup to 3 times longer than other, similar, short-term studies.…”

Section: Discussionmentioning

confidence: 60%

Withdrawal of maintenance digoxin from institutionalized elderly

Macarthur

1990

Postgraduate Medical Journal

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Summary: Chronic use of digitalis is common amongst the institutionalized elderly. Associated with digitalis use is the potential for toxicity and/or adverse reactions. In this study maintenance digoxin was withdrawn from 14 elderly nursing home residents in sinus rhythm. Subjects were followed over 18 months for evidence of dysrhythmia or heart failure. One resident had an episode of supraventricular tachycardia which required digoxin to be restarted. One resident developed left heart failure, treated with oral diuretic. For 12 of the 14 residents, withdrawal of maintenance digoxin was achieved without deleterious effect. This study suggests that maintenance digoxin may be withdrawn safely in elderly nursing home residents in sinus rhythm and without history of atrial dysrhythmia.

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Section: Discussionmentioning

confidence: 60%

Withdrawal of maintenance digoxin from institutionalized elderly

Macarthur

1990

Postgraduate Medical Journal

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“…There is no question that one ofthe major factors contributing to adverse drug effects, poor treatment outcome and drug interactions is multiple drug use (Lamy 1986). This use has been called 'polypharmacy' or 'polymedicine'.…”

Section: Polypharmacymentioning

confidence: 99%

“…Adverse drug reactions and interactions rise exponentially with the number of drugs a patient receives (Lamy 1986(Lamy , 1990, and occur most often in the nursing home population, particularly when drugs are prescribed on an as-needed basis. In addition to an increased risk for drug-drug interactions when multiple drugs are prescribed, there is also an increased risk of drug-disease interactions.…”

Section: Polypharmacymentioning

confidence: 99%

“…For example, ,a-blockers as a treatment for antipsychotic-resistant psychosis are contraindicated in the patient with asthma, atrioventricular conduction defects or congestive heart failure, although recently a beneficial role for ,a-blockers in congestive heart failure has been proposed. Multiple drug use further leads to use of drugs with different therapeutic effects but often the same adverse effect profile, with a consequent accumulation of adverse effects (Lamy 1986(Lamy , 1990.…”

Section: Polypharmacymentioning

confidence: 99%

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Institutionalisation and Drug Use in Older Adults in the US

Lamy

1993

Drugs & Aging

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Since the introduction of Medicaid and Medicare in the US in 1965, the rate of use of nursing homes by elderly persons has more than doubled. Nursing home care accounts for about 8% of the healthcare budget. The rate of nursing home use by elderly people and the subsequent costs are expected to increase during the 1990s. The elderly nursing home population have a disproportionately high rate of drug consumption; it has been estimated that up to one-third of elderly nursing home residents receive 8 to 12 drugs per day. Multiple drug use is a risk factor for morbidity in elderly patients. Recent regulations have tried to rationalise the use of particular classes of drugs in nursing homes, with some success. However, multiple drug use is not necessarily unjustified, given the complex comorbidity seen in some patients. Since the value of many drugs has not been proven in the elderly population, further studies are required to prove the value of drugs used in this patient population in improving function and quality of life. Regular review of total regimens should be undertaken often.

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“…Patients in the assisted living sector receive more drugs than those living in the com munity, and community-living elderly re ceive more drugs than younger adults. An increased number of drugs is a major fac tor in patient confusion and an increased rate of adverse drug reactions (15).…”

Section: Need For An Individualized Approachmentioning

confidence: 99%