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drug adverse effect(s)
Etiology:
risk factors
- age > 85 years
- low BMI
- >= 6 chronic diagnoses
- estimated creatinine clearance of < 50 mL/min
- >= 9 medications
- >= 12 medication doses/day
- prior adverse drug effect [3]
- hospital discharge of older adults (20%) [4]
- 1/3 considered preventable
- 17% involve drugs on Beer's list [4]
Epidemiology:
- elderly at 2-fold risk, 7-fold risk of hospitalization
- 4 medications account for 2/3 of hospitalizations [2]
- warfarin (33%)
- insulin (14%)
- antiplatelet agents (13%)
- oral hypoglycemic agents (11%)
- most commonly implicated drugs leading to emergency department visits by age [6]
- > 64 years: anticoagulants, clopidogrel, insulin
- 45-64 years: insulin & warfarin
- 25-44 years: alprozolam & insulin
- 15-24 years: alprozolam & ibuprofen [6]
- low visual acuity & low health literacy increase risk for drug dosing errors & other unintentianal misuse of drugs [5]
Notes:
- see adverse drug reaction for:
a) type A drug reaction
b) type B drug reaction
Related
adverse drug reaction (ADR)
Specific
adverse drug effects in the elderly
antibiotic side effects in the elderly
antibiotic-associated diarrhea (AAD)
cannabinoid/cannabis hyperemesis syndrome
common prescription drugs associated with insomnia
differentiation syndrome
diuretic resistance
drug adverse effects of 5-alpha reductase inhibitors
drug adverse effects of ACE inhibitors
drug adverse effects of ADHD medications
drug adverse effects of adrenergic receptor agonists
drug adverse effects of alkylating agents
drug adverse effects of alpha-1 adrenergic receptor antagonists
drug adverse effects of alpha-adrenergic receptor agonists
drug adverse effects of aminoglycosides
drug adverse effects of analeptics
drug adverse effects of androgens
drug adverse effects of angiotensin II receptor antagonists
drug adverse effects of antacid(s)
drug adverse effects of anthracyclines
drug adverse effects of anti-Alzheimer monoclonal antibody
drug adverse effects of anti-bacterial agent(s)
drug adverse effects of anti-hyperlipidemic agents
drug adverse effects of antiarrhythmic agent, Group IA
drug adverse effects of antiarrhythmic agent, Group IC
drug adverse effects of antiarrhythmic agent, Group III
drug adverse effects of anticonvulsants
drug adverse effects of antidepressants
drug adverse effects of antihypertensive agents
drug adverse effects of antimalarials
drug adverse effects of antiplatelet agents
drug adverse effects of antipsychotic agents
drug adverse effects of antiretroviral agents
drug adverse effects of antiretroviral protease inhibitors
drug adverse effects of antithrombotic agent(s)
drug adverse effects of antithyroid agent(s)
drug adverse effects of antitussive agent(s)
drug adverse effects of aromatase inhibitors
drug adverse effects of atypical antipsychotic agents
drug adverse effects of benzodiazepines
drug adverse effects of beta-1 adrenergic receptor antagonists
drug adverse effects of beta-adrenergic receptor agonists
drug adverse effects of beta-adrenergic receptor antagonists
drug adverse effects of biologic immunosuppressive agents
drug adverse effects of bisphosphonates
drug adverse effects of calcineurin inhibitors
drug adverse effects of calcium channel blockers
drug adverse effects of calclium supplement(s)
drug adverse effects of carbonic anhydrase inhibitor(s)
drug adverse effects of cephalosporins
drug adverse effects of checkpoint inhibitor(s)
drug adverse effects of cholinesterase inhibitors
drug adverse effects of contrast agents
drug adverse effects of COX-2-specific inhibitors
drug adverse effects of direct oral anticoagulants
drug adverse effects of diuretics
drug adverse effects of dopaminergic receptor agonists
drug adverse effects of dopaminergic receptor antagonists
drug adverse effects of EGF receptor inhibitors
drug adverse effects of erythropoiesis-stimulating agents
drug adverse effects of estrogens
drug adverse effects of fibrates
drug adverse effects of fluoroquinolones
drug adverse effects of gabapentinoids
drug adverse effects of ginsengs
drug adverse effects of gliptins
drug adverse effects of glitazones
drug adverse effects of glucocorticoids
drug adverse effects of glycoprotein IIb/IIIa inhibitor
drug adverse effects of GnRH agonists
drug adverse effects of H1 receptor antagonists
drug adverse effects of H2-receptor antagonists
drug adverse effects of HMG CoA reductase inhibitors
drug adverse effects of hormonal contraception
drug adverse effects of hypoglycemic agents
drug adverse effects of immunosuppressive agents
drug adverse effects of incretin mimetics
drug adverse effects of janus kinase inhibitors
drug adverse effects of leukotriene receptor antagonists
drug adverse effects of lipophilic statins
drug adverse effects of LMW heparin
drug adverse effects of long-acting beta-adrenergic receptor agonists
drug adverse effects of loop diuretics
drug adverse effects of macrolide(s)
drug adverse effects of MAO inhibitors
drug adverse effects of neuraminidase inhibitor(s)
drug adverse effects of nitrites
drug adverse effects of nitrofurantoin
drug adverse effects of non-nucleoside reverse transcriptase inhibitors (NNRTI)
drug adverse effects of NSAIDs
drug adverse effects of opiates
drug adverse effects of oral glucosuric agent; SGLT-2 inhibitor; flozin
drug adverse effects of P2Y12 receptor inhibitor(s)
drug adverse effects of parasympatholytics
drug adverse effects of PCSK9 inhibitor(s)
drug adverse effects of pharmaceutical monoclonal antibodies
drug adverse effects of phosphodiesterase-5-inhibitors
drug adverse effects of platinum-based chemotherapy
drug adverse effects of proton pump inhibitors (PPI)
drug adverse effects of psychotropic agents
drug adverse effects of renin-angiotensin-aldosterone system inhibitors (RAAS inhibitors)
drug adverse effects of sedatives
drug adverse effects of SSRIs
drug adverse effects of sulfonamides
drug adverse effects of sulfonylureas
drug adverse effects of sympathomimetic(s)
drug adverse effects of thiazide diuretics
drug adverse effects of thiazolidinediones
drug adverse effects of thiopurines
drug adverse effects of TNF-alpha inhibitors
drug adverse effects of topical glucocorticoids
drug adverse effects of tricyclic antidepressants
drug adverse effects of triptan(s)
drug adverse effects of tumor necrosis factor (TNF) inhibitors
drug adverse effects of tyrosine kinase inhibitor(s)
drug dependence
drug-induced glomerulonephritis (GN)
drug-seeking behavior
drugs associated with hyponatremia
drugs associated with myopathy
drugs associated with weight gain
drugs that increase vasopressin or enhance its action
intoxication
medications causing dysphagia
opioid-induced constipation (OIC)
pharmaceutical agents associated with confusion
pharmaceutical agents associated with diarrhea
pharmaceutical agents associated with headache
pharmaceutical agents associated with myalgia
pharmaceutical agents associated with seizures; drugs that lower seizure threshold
pharmaceutical agents causing leg cramps
substance abuse
General
adverse effect
References
- Budnitz DS et al,
National surveillance of emergency department visits for
outpatient adverse drug events.
JAMA 2006, 296:1858
PMID: 17047216
- Budnitz DS et al,
Medication use leading to emergency department visits for
adverse drug events in older adults.
Ann Intern Med 2007, 147:755
PMID: 18056659
- Budnitz DS, Lovegrove MC, Shehab N, Richards CL.
Emergency hospitalizations for adverse drug events in older
Americans.
N Engl J Med 2011; 365:2002-2012
PMID: 22111719
- Geriatric Review Syllabus, 8th edition (GRS8)
Durso SC and Sullivan GN (eds)
American Geriatrics Society, 2013
- Kanaan AO et al.
Adverse drug events after hospital discharge in older adults:
Types, severity, and involvement of Beers criteria medications.
J Am Geriatr Soc 2013 Nov; 61:1894
PMID: 24116689
- Mullen RJ, Curtis LM, O'Conor R, et al.
Visual acuity, literacy, and unintentional misuse of
nonprescription medications.
Am J Health Syst Pharm. 2018;75:e213-e220.
PMID: 29691264
https://psnet.ahrq.gov/resources/resource/31865
- Budnitz DS, Shehab N, Lovegrove MC et al
US Emergency Department Visits Attributed to Medication Harms, 2017-2019.
JAMA. 2021;326(13):1299-1309.
PMID: 34609453 PMCID: PMC8493432 (available on 2022-04-05)
https://jamanetwork.com/journals/jama/article-abstract/2784662