Main Article Content
Abstract
Background
Drug use is frequently considered to be hazardous for an elderly, due to greater vulnerability of an elderly to drugs and multiple drug use. Poly-pharmacy is unavoidable in the elderly as they suffer from multiple co-morbidities. Adverse drug reaction (ADR) is the sixth leading cause of death. Drug-drug interaction due to polypharmacy and potentially inappropriate medication must be carefully assessed.
Material and methods
The study was conducted in both Inpatient and Outpatient in all departments of Thumbay Hospital New Life, Hyderabad for 6 months from October 2018 to March 2019.537 prescriptions was randomly collected and evaluated for adverse drug reactions and clinical consequences of drug interactions and polypharmacy in patients presenting to a secondary care Hospital.
Results
A total of 537 patients were observed of which 203 patients experienced ADR’s which accounted for 21.5% of the incidence and 143 DDI’s were observed. Most of the DDI’s were Pharmacokinetic drug interactions (26.7%) followed by Pharmacodynamic drug interactions (12.70%). A severity assessment showed that the majority of DDI’s were moderate 34.96% followed by minor 32.86%. Poly-pharmacy was more frequent in the elderly of age 56-65 (both males and females) and totally 321 ADEs were observed and the incidence of ADR’s and DDI’s increased non-significantly as the number of drugs used for long term period. Majority of ADRs were suspected due to antibiotics, anti-hypertensive responsible for causing GI complaints and rash. Neurological system (26%) was the most common organ system affected due to ADRs. In the cases of treating LRTI and urinary tract infections, there was an enormous risk of ADR’s. The number of drugs increases as the age and the co-morbid conditions increases with an average of 20.
Conclusion
From the present study we can conclude that relatively high incidence of Adverse drug reactions has been recorded which shows that not only geriatric patients but also adults are also more susceptible to ADR’s and poly-pharmacy leads to serious DDI’s and hence to improve drug safety- appropriate prescribing, TDM is important.
Keywords
Article Details
References
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- [2]. Mir S. Adil et al ; Causality Assessment of Adverse drug reactions in Pulmonology Department of a Tertiary Care Hospital, 2015 PMCID :PMC4513336.
- [3]. Cesar de Oliveria et al; Drug - Drug Interaction and adverse drug reactions in polypharmacy among older adults : an integrative review, 2016 PMCID : PMC5016009.
- [4]. Dharani Kalyansundaram et al ; Study on polypharmacy and potential Drug drug interaction among Elderly Patients Admitted in Department of Medicine of a Tertiary Care Hospital in Puducherry, 2016 PMCID: PMC4800545.
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- [6]. LIG Vehoof et al; Adverse drug reaction and polypharmacy in the elderly in general practice, 1, 2000, PMID10846147.
- [7]. K.Nematullah et al; Casuality Assessment of adverse drug reaction in Pulmonology Department of a Tertiary Care Hospital, 2015: PMCID: PMC4513336.
- [8]. K. Aamer et al ; Casuality Assessment of adverse drug reaction in Pulmonology Department of a Tertiary Care Hospital, 2015:PMCID :PMC4513336.
- [9]. Joseph T. Halon et al; Clinical Consequences of Polypharmacy in elderly, 2014, PMCID: PMC3864987.
- [10]. P. Khazaelli et al; Prevalence of potential Drug interactions in an Iranian general Hospital, January 2012, PMCID: PMC3507350.
- [11]. Maria Cristina Soares Rodrigues et al ; Drug –drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review; Researcher Department Epidermology and public Health, University college london ,UK; 2016; PMCID ; PMC5016009.
- [12]. Munir Pirmohamed et al; Adverse drug reactions as cause of admission to hospital ;Prospective Analysis of 18820 patients; Department of pharmacology and Therapeutics, University of Liverpool; 11, 2004 PMCID; PMC443443.
- [13]. Vijay Kulkarni et al ;A Study on drug –drug interactions through Prescription analysis in a south Indian teaching Hopital; Tamil Nadu, India 2013 ; PMCID ; PMC4125320.
- [14]. Kartik JanardanSalwe rt al ; A study on polypharmacy and potential Drug – drug interactions among Elderly Patients Admitted in Department of Medicine of a Tertiary Care Hospital in Puducherry; 1, 2016, PMCID; PMC4800545.
- [15]. G. Sepehri et al; Prevalence of potential Drug Interaction in an Iranian General hospital, 2012, PMCID: PMC3507350. Study, 1998.
- [16]. KD Tripathi et al; Drug Interactions pg.no: 928.
- [17]. Parthasarathi et al; Adverse drug reactions. Drug Interactions 104- 123.
References
[1]. H Khalid et al: Prevalence and pharmacokinetic drug drug interactions in older aged psychiatric patients, 2012 PMCID: PMC3507350.
[2]. Mir S. Adil et al ; Causality Assessment of Adverse drug reactions in Pulmonology Department of a Tertiary Care Hospital, 2015 PMCID :PMC4513336.
[3]. Cesar de Oliveria et al; Drug - Drug Interaction and adverse drug reactions in polypharmacy among older adults : an integrative review, 2016 PMCID : PMC5016009.
[4]. Dharani Kalyansundaram et al ; Study on polypharmacy and potential Drug drug interaction among Elderly Patients Admitted in Department of Medicine of a Tertiary Care Hospital in Puducherry, 2016 PMCID: PMC4800545.
[5]. B Meyboom de Jong et al; Adverse drug reaction and polypharmacy in the elderly in general practice, 1, 2000. PMID10846147
[6]. LIG Vehoof et al; Adverse drug reaction and polypharmacy in the elderly in general practice, 1, 2000, PMID10846147.
[7]. K.Nematullah et al; Casuality Assessment of adverse drug reaction in Pulmonology Department of a Tertiary Care Hospital, 2015: PMCID: PMC4513336.
[8]. K. Aamer et al ; Casuality Assessment of adverse drug reaction in Pulmonology Department of a Tertiary Care Hospital, 2015:PMCID :PMC4513336.
[9]. Joseph T. Halon et al; Clinical Consequences of Polypharmacy in elderly, 2014, PMCID: PMC3864987.
[10]. P. Khazaelli et al; Prevalence of potential Drug interactions in an Iranian general Hospital, January 2012, PMCID: PMC3507350.
[11]. Maria Cristina Soares Rodrigues et al ; Drug –drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review; Researcher Department Epidermology and public Health, University college london ,UK; 2016; PMCID ; PMC5016009.
[12]. Munir Pirmohamed et al; Adverse drug reactions as cause of admission to hospital ;Prospective Analysis of 18820 patients; Department of pharmacology and Therapeutics, University of Liverpool; 11, 2004 PMCID; PMC443443.
[13]. Vijay Kulkarni et al ;A Study on drug –drug interactions through Prescription analysis in a south Indian teaching Hopital; Tamil Nadu, India 2013 ; PMCID ; PMC4125320.
[14]. Kartik JanardanSalwe rt al ; A study on polypharmacy and potential Drug – drug interactions among Elderly Patients Admitted in Department of Medicine of a Tertiary Care Hospital in Puducherry; 1, 2016, PMCID; PMC4800545.
[15]. G. Sepehri et al; Prevalence of potential Drug Interaction in an Iranian General hospital, 2012, PMCID: PMC3507350. Study, 1998.
[16]. KD Tripathi et al; Drug Interactions pg.no: 928.
[17]. Parthasarathi et al; Adverse drug reactions. Drug Interactions 104- 123.