Doucet et al studied risk factors associated with adverse drug reactions in elderly patients admitted to the hospital. Recognition of these risk factors can help the physician adjust a patient's medications and dosages to reduce untoward side effects. The authors are from Rouen, France.
Risk factors associated with most adverse drug reactions in the elderly:
(1) drug-drug interactions (reactions may be either preventable or nonpreventable)
(2) excessive dose (usually preventable)
(3) related to an existing chronic disease (usually preventable)
(4) development of acute illness (usually nonpreventable)
General rules:
(1) Keep the number of medications that a patient is taking to a minimum.
(2) Keep the dosing schedule as simple as possible.
(3) Keep the dose of a medication at the lowest effective dose
(4) Adjust the usual adult drug dose to take into account the physiologic changes in the elderly.
(5) Review the potential drug interactions for all drug combinations
(6) Evaluate the impact of starting, stopping or changing a medication.
(7) Change in the severity of existing condition may require modification of an existing drug regimen.
(8) The onset of an acute illness may require modification of the existing drug regimen during the acute episode and readjustment on recovery.
(9) Drug monitoring may be helpful in dosage adjustment when an acute disease occurs.
