According to the CDC, each year, millions of adults aged 65 and older fall.
Falls in older adults can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.
In 2013, 2.5 million non-fatal falls amoung older adults were treated in emergency rooms and more than 734,000 of those patients were hospitalized costing an estimated $34 billion.
Drug-related problems are common in the elderly and include overdose, underdosage, adverse effects and drug-on-drug interactions.
Adverse drug effects often happen in the elderly for many reasons. The elderly often take many drugs (polypharmacy) and have age-related changes in pharmacodynamics and pharmacokinetics; both increase the risk of adverse effects.
Adverse effects are thought to be preventable in almost 90% of cases in the elderly (compared with only 24% in younger patients). Certain drug classes are commonly involved: antipsychotics, warfarin, antiplatelet agents, hypoglycemic drugs, antidepressants, and sedative-hypnotics.
Warfarin, along with hunderds of other prescription medications have a Black Box Warning on the label. This warning recommends a pharmacogenomic test to avoid adverse events.
Pharmacogenomics can play an important role in identifying responders and non-responders to medications, avoiding adverse events, and optimizing drug dose. Drug labeling may contain information on genomic biomarkers and can describe:
- Drug exposure and clinical response variability
- Risk for adverse events
- Genotype-specific dosing
- Mechanisms of drug action
- Polymorphic drug target and disposition genes
A prescribing cascade occurs when the adverse effect of a drug is misinterpreted as a symptom or sign of a new disorder and a new drug is prescribed to treat it. The new, unnecessary drug may cause additional adverse effects, which may then be misinterpreted as yet another disorder and treated unnecessarily, and so on.
By using a pharmacogenomic test, healthcare professionals avoid the “trial and error” process and can help prevent falls and possible death due to falls among the elderly. This test will help determine the right drug, at the right dose, for each individual. It takes away the “guess work” and provides physicians and pharmacist with scientific evidence that they would otherwise not know.
In elderly patients, prescribers should always consider the possibility that a new symptom or sign is due to drug therapy. And in order to determine whether a drug is even capable of working, a pharmacogenomic test can be preformed and help guide in patient care to help prevent falls and hospitalization.
For more information on pharmacogenomic testing, contact:
PGx Medical
Individualized Care – Personalized Medicine
405-509-5112
info@pgxmed.com
Empowerment at the Source of Treatment
Source: cdc.gov, merckmanuals.com, fda.gov