When a resident of our retirement community said his statin was causing memory loss, I at first did not believe him. Then he tried another statin and the same reaction happened. This was THE event that opened my eyes to the very issue of adverse drug events in older adults.
Adverse drug events (ADE’s), also called side-effects, are responsible for 2.2 million hospital visits and 106,000 deaths each year! If ADE’s were a disease by itself, it would be the 5th leading cause of death by disease. This becomes more likely as we age since we are more sensitive to the effects of most medications and we tend to take more medications.
What is described above is called orthostatic hypotension. It is best described as dizziness upon standing up from a seated or lying down position which can compromise blood flow to the brain thereby causing dizziness. This is a leading cause of falling in older adults but can be easily remedied. When blood pressure is affected by medications used to treat a cardiovascular condition such as high blood pressure there is an increased risk of experiencing this syndrome. Although many medications can cause dizziness by different mechanisms, we will focus on those that affect blood pressure.
Accountable Care Organizations (ACOs) may want to look a little deeper as to why many of their hospital patients who recently discharged are coming back within 30-days. An article in Annals of Internal Medicine, The Incidence and Severity of Adverse Events Affecting Patients after Discharge from the Hospital, Alan Forster, MD, et al, 2003;138:161-167, stated that 66% of the measured adverse events after discharge were adverse drug events. This point is also emphasized in a presentation by Dr. Steve Hines, PhD, and found on the AHRQ website.
I was talking with a resident at a diabetes support group I was leading and coaching him on the need to take a statin to lower his cholesterol, since he was at high risk for a cardiovascular event such as a heart attack or stroke. He said he could not take a statin since the one he tried caused him to be “goofy and loopy” and that he experienced “memory loss”. I said, “Balderdash”!
Meta-analysis suggests that combination therapy causes more harm than benefit and should be limited to high-risk groups.
Learn the critical concepts that can help prevent harm from medication use in older adults.
One major study from Canada, involving over 300,000 cases, showed a 43% increase in risk for hip fracture within 45 days.
Renal failure from PPIs was confirmed in one study where 296 biopsies were studied, and of 24 cases of acute interstitial nephritis, 14 were drug-induced and eight of those were from PPIs
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For Some Troops, Powerful Drug Cocktails Have Deadly Results
http://www.nytimes.com/2011/02/13/us/13drugs.html?emc=eta1
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