Drugs That put 'Old Folks' in the Hospital

Diabetes and cardiovascular drugs implicated in majority of emergency hospitalizations

(RxWiki News) While medicines help millions of patients battle their illnesses, they also have potentially dangerous side effects. Older adults are especially at risk of hospitalization related to their drug treatments.

Only a handful of drugs are responsible for most of the emergency visits to the hospital among elderly adults hospitalized for drug side effects.

"Ask your doctor about the possible Rx side effects."

In a recent study, Daniel S. Budnitz, M.D., M.P.H., director of the Centers for Disease Control and Prevention's Medication Safety Program, and colleagues wanted to find out how often and how many older U.S. adults were hospitalized as a result of harmful drug side effects.

"Adverse drug events are important preventable causes of hospitalization in older adults," the authors write. "However, nationally representative data on adverse drug events that result in hospitalization in this population have been limited."

Looking at data from the National Electronic Injury Surveillance System, the researchers found there were nearly 100,000 emergency hospitalizations due to harmful drug events among US adults over the age of 65.

Almost half of these hospitalizations involved people over the age of 80.

The majority of these hospitalizations were associated with just four medications: warfarin (a drug for preventing blood clots), insulins (used in diabetes treatment), oral antiplatelet agents (used to fight cardiovascular disease), and oral hypoglycemic agents (used to treat and prevent low blood sugar, particularly in those with diabetes).

According to the authors, "Most emergency hospitalizations for recognized adverse drug events in older adults resulted from a few commonly used medications, and relatively few resulted from medications typically designated as high-risk or inappropriate."

In other words, the four drugs responsible for the most hospitalizations are commonly used and generally considered safe. Drugs that are thought to be high-risk were responsible for only 1.2 percent of the hospitalizations in the study. In comparison, warfarin, insulins, antiplatelet drugs, and hypoglycemic drugs were implicated in 67 percent of the hospitalizations.

These findings demonstrate that doctors, drug experts, and patients need to work together to improve management of drugs commonly used by patients with diabetes or cardiovascular problems.

"Improved management of antithrombotic and antidiabetic drugs has the potential to reduce hospitalizations for adverse drug events in older adults," the authors write.

Warfarin is marketed under the brand names Coumadin, Jantoven, and Marfarin.

Examples of oral antiplatelet drugs include Aspirin, Plavix, Effient, Brilinta, and Ticlid.

Examples of hypoglycemic drugs include Fortamet, Glucophage, Glumetza, Riomet, Amaryl, Glucotrol, and Metaglip.

This study was published in The New England Journal of Medicine.