Risks for adverse drug reactions in the elderly.

• Risk factors for adverse drug reactions in the elderly-

  • Inappropriate prescribing is common in the elderly due to multiple presentations to multiple single organ Doctors (SODs) where everyone is adding their little bit of medication, but there is no-one overall coordinating the treatment.

  • Poor geriatric prescribing knowledge and lack of awareness of how the elderly body handles the medications.

  • Glossy advertisements with little data specific for the elderly, with many drugs specifically studied in younger, fitter, paid volunteers, with minimal data extrapolated for marketing for the elderly.

  • The elderly have impaired reserve to tolerate larger doses of drugs. 

  • The most important risk factor for adverse drug reactions is the number of drugs taken.

  • Older people are more prone to Type A adverse drug reactions which are dose related, predictable, and related to the pharmacological actions of the drug. 

  • Malnourished elderly have a much higher risk of adverse drug reactions because they have a decreased body mass and muscle mass is a good sump for absorbing drugs to prevent side effects.  There is decreased serum albumin (protein in the circulation) to bind the free drug.

  • Adverse drug reactions are commonly missed and more importantly, drug interactions or drug to drug effects are even more commonly missed. 

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.