The ambiguous relation between aging and adverse drug reaction

Article Abstract:

It has been observed than older patients experience more negative side effects from prescribed drugs than younger patients. The precise reasons for this are unknown. Some suggest that aging itself is a risk factor for adverse drug effects, while others believe that the fact that the elderly often consume multiple drugs and have more underlying illnesses can explain their more frequent adverse drug effects. One complicating factor in determining the true frequency of adverse drug effects is that the extremely old are often excluded from drug trials. They may also be less able to withstand the particular adverse effect being considered. An occasional cause of adverse drug effect is the failure to reduce the dosage of the drug to accommodate the elderly patient's decreased ability to metabolize and clear the drug from his system. Some specific categories of drugs associated with greater adverse effects in elderly patients include the benzodiazepines, tranquilizer often prescribed for anxiety. Several studies have shown an increased risk of hip fracture in the elderly who take these drugs, which is attributed to the excess drowsiness and balance problems that the elderly can experience with benzodiazepines. Another problematic category of medications is that of the nonsteroidal anti-inflammatory drugs, a group of pain relievers often prescribed for the treatment of arthritis. Several studies have shown an increased risk for gastrointestinal hemorrhage in the elderly taking these drugs. Isoniazid, a drug to treat tuberculosis, can cause an irreversible hepatitis, and the risk appears to increase with advancing age. Chemotherapeutic agents used in cancer treatments are often prescribed carefully for the elderly, but studies show that the elderly generally tolerate the adverse effects of chemotherapy. Relatively few data exist that conclusively show the range and degree of adverse drug effects in the elderly. Greater representation of the very old in preliminary drug trials might elucidate these issues. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drugs, Testing, Physiological aspects, Demographic aspects, Adverse drug reactions

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Drug use in the nursing home

Article Abstract:

Nursing homes and drug researchers may be able to improve the management and formulation of medications for elderly patient. Researchers reviewed some common practices of drug management in nursing homes and offered some suggestions for improvement. Admission to a nursing home may be a good opportunity to review a patient's current medication and possibly monitor the withdrawal of some unnecessary and costly medications. Nursing homes may be able to reduce the excess use of many medications by improving diet, staff interaction, and physical activity levels. Nursing homes may overlook or misdiagnose cases of depression and consequently overlook the use of antidepressant drugs. Vaccinating patients and ensuring proper intake of calcium can help to prevent costly outbreaks of infectious disease and bone injuries. Researchers who test medications used by the elderly should consider including elderly patients in their studies and consider the special physical characteristics of an aging body as it interacts with medication.

Nursing home patients, Long term care

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Antihypertensive drug therapy and the initiation of treatment for diabetes mellitus

Article Abstract:

Hypertensive patients who are treated with thiazide diuretics may not have a higher risk of developing hyperglycemia than patients taking other antihypertensive drugs. Hyperglycemia is characterized by elevated blood glucose (sugar) levels and can be a precursor of diabetes. Thiazide diuretics can adversely effect glucose metabolism in the body. A study compared the use of antihypertensive drugs among 11,855 patients who began treatment for hyperglycemia with insulin or another drug between 1981 and 1990 to 11,855 individuals who did not begin treatment for hyperglycemia during this period. Patients treated with thiazide diuretics did not have a significantly higher risk of developing hyperglycemia than patients taking other drugs. Patients treated with a combination of drugs for hypertension had a slightly higher risk of developing hyperglycemia than other patients regardless of whether or not thiazide diuretics were included in the treatment regime.

Hypertension, Risk factors, Diabetes, Diabetes mellitus, Antihypertensive drugs, Antihypertensive agents, Thiazides

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