CDA Oasis Conversations: Managing adverse drug reactions in the elderly

Dr. Aviv Ouanounou speaks with Dr. Suham Alexander about adverse drug reactions and their management in the elderly population.

Interview Highlights

Adverse drug reactions are undesired or unexpected effects which occur in patients at therapeutic dosages. These differ from side-effects of medications which are known ahead of time through clinical trials and have been detailed in drug monographs.

Causes of adverse drug reactions

• Use of multiple medications (polypharmacy).
• Many medications are not trialed in the elderly therefore, there is no information about reactions or side-effects that may occur in this population.
• Altered physiology, metabolism and pharmacokinetics in the elderly.

Common Adverse Drug Reactions

• Opioids – escalated effects of constipation, respiratory depression, dizziness.
• NSAIDs – reactions with ACE inhibitors, diuretics, beta blockers, anticoagulants, SSRIs.
• Clindamycin – pseudomembranous colitis is a severe complication.
• Epinephrine and beta-blockers.

Prevention and Management

1. Accurate and thorough medical, drug history.
2. Assess risks and benefits to prescribing medication.
3. Discontinue or modify dosage and/or route of administration of medications (depending on severity) that may be causing an adverse reaction.
4. Make detailed notes in the chart about any adverse reaction that occurs, the management and the outcome of the situation.

Watch the video interview