Adverse drug effects can occur in any patient, but certain characteristics of the elderly make them more susceptible. An elderly person often takes many drugs (polypharmacy). They also have age-related changes that increase the risk of adverse effects.
Many drugs have adverse effects that resemble symptoms of disorders common among the elderly or changes due to aging.
Antipsychotics may cause symptoms that resemble Parkinson disease. In elderly patients, these symptoms may be diagnosed as Parkinson disease and treated, possibly leading to adverse effects from the antiparkinson drugs (eg, orthostatic hypotension, delirium, nausea).
A drug-drug interaction may increase or decrease the effects of one or both drugs. Clinically significant interactions are often predictable and usually undesired. Adverse effects or therapeutic failure may result. Rarely, clinicians can use predictable drug-drug interactions to produce a desired therapeutic effect.
Adverse effects of inappropriate drugs account for about 7% of emergency hospitalizations for patients ≥ 65 yr, and 67% of these hospitalizations are due to 4 drugs or drug classes—warfarin, insulin, oral antiplatelet drugs, and oral hypoglycemic drugs.
Despite the Beers and other criteria, inappropriate drugs are still being prescribed for the elderly; typically, about 20% of community-dwelling elderly received at least one inappropriate drug. In such patients, risk of adverse effects is increased. In nursing home patients, inappropriate use also increases risk of hospitalization and death. In one study of hospitalized patients, 27.5% received an inappropriate drug.
Tools to help reduce adverse events:
Pharmacogenetics is a simple test (swab of the cheek) that can help physicians and other healthcare professionals determine if a drug is appropriate for that individual. Does the drug have the ability, based on that person’s genetic make-up to give them therapy? Are there drug-on-drug interactions that you aren’t aware of? This test can guide clinicians in making actionable clinically based decisions to provide a better quality of life. Making the “guessing game” a thing of the past.
For more information on pharmacogenetics in the aging services industry, contact: PGx Medical, info@pgxmed.com or 405-509-5112.
source: merckmanuals