Understanding adverse drug reactions in older adults through drug–drug interactions

ABSTRACT Objective: to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. Methods: an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed. Results: forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing. Conclusions: DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps.

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Polypharmacy Adverse Drug Reactions (PADRe): Nurse-led Intervention to Minimise Adverse Drug Reactions for Older Adults in Care Homes: a Quality Improvement Process Intervention

Case Medical Research ◽

10.31525/ct1-nct03955133 ◽

2019 ◽

Author(s):

Keyword(s):

Older Adults ◽

Quality Improvement ◽

Adverse Drug Reactions ◽

Care Homes ◽

Drug Reactions ◽

Quality Improvement Process ◽

Improvement Process

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Biology of Heme: Drug Interactions and Adverse Drug Reactions with CYP450

Current Topics in Medicinal Chemistry ◽

10.2174/1568026619666181129124638 ◽

2019 ◽

Vol 18 (23) ◽

pp. 2042-2055 ◽

Cited By ~ 4

Author(s):

Neeraj Kumar ◽

Heerak Chugh ◽

Damini Sood ◽

Snigdha Singh ◽

Aarushi Singh ◽

...

Keyword(s):

Cytochrome P450 ◽

Drug Metabolism ◽

Drug Interactions ◽

Adverse Drug Reactions ◽

Genetic Defects ◽

Drug Reactions ◽

Detailed Structure ◽

Synthesis And Degradation ◽

Porphyrin Rings

Heme is central to functions of many biologically important enzymes (hemoproteins). It is an assembly of four porphyrin rings joined through methylene bridges with a central Fe (II). Heme is present in all cells, and its synthesis and degradation balance its amount in the cell. The deregulations of heme networks and incorporation in hemoproteins lead to pathogenic state. This article addresses the detailed structure, biosynthesis, degradation, and transportation associated afflictions to heme. The article is followed by its roles in various diseased conditions where it is produced mainly as the cause of increased hemolysis. It manifests the symptoms in diseases as it is a pro-oxidant, pro-inflammatory and pro-hemolytic agent. We have also discussed the genetic defects that tampered with the biosynthesis, degradation, and transportation of heme. In addition, a brief about the largest hemoprotein group of enzymes- Cytochrome P450 (CYP450) has been discussed with its roles in drug metabolism.

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Adverse drug reactions & drug interactions in MDR-TB patients

Indian Journal of Tuberculosis ◽

10.1016/j.ijtb.2020.09.027 ◽

2020 ◽

Vol 67 (4) ◽

pp. S69-S78

Author(s):

Amitesh Gupta ◽

Vikas Kumar ◽

Sekar Natarajan ◽

Rupak Singla

Keyword(s):

Drug Interactions ◽

Adverse Drug Reactions ◽

Drug Reactions ◽

Mdr Tb

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Importance of cytochrome P450 (CYP450) in adverse drug reactions due to drug–drug interactions: a PharmacoVigilance study in France

European Journal of Clinical Pharmacology ◽

10.1007/s00228-012-1394-3 ◽

2012 ◽

Vol 69 (4) ◽

pp. 885-888 ◽

Cited By ~ 17

Author(s):

Anne Charlotte Danton ◽

François Montastruc ◽

Agnès Sommet ◽

Geneviève Durrieu ◽

Haleh Bagheri ◽

...

Keyword(s):

Cytochrome P450 ◽

Drug Interactions ◽

Adverse Drug Reactions ◽

Drug Reactions

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24In-Hospital Adverse Drug Reactions in Hospitalised Older Adults - A Systematic Review

Age and Ageing ◽

10.1093/ageing/afy140.14 ◽

2018 ◽

Vol 47 (suppl_5) ◽

pp. v13-v60 ◽

Cited By ~ 1

Author(s):

Emma Jennings ◽

Kevin Murphy ◽

Paul Gallagher ◽

Denis O’Mahony

Keyword(s):

Systematic Review ◽

Older Adults ◽

Adverse Drug Reactions ◽

Drug Reactions

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Drug-Drug-Dietary interactions in pharmacotherapy of GIT medication: A review

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4579 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2903-2909

Author(s):

Akula sowjanya ◽

Abhisek Pal

Keyword(s):

Drug Therapy ◽

Drug Interactions ◽

Food Consumption ◽

Adverse Drug Reactions ◽

Drug Effect ◽

Google Scholar ◽

Drug Reactions ◽

Common Drug ◽

Different Types ◽

Dietary Interactions

Successful drug therapy depends on the interaction between drug-drug and drug-diet. Drug interactions are a vital reason for causing adverse drug reactions and modify one drug effect by another drug and these kinds of interactions can increase or decrease the effectiveness of the drug. Polypharmacy could be a major risk for Drug-Drug and Drug-food interactions. Food Consumption can alter the effect of drugs by interfering either with their pharmacokinetics or pharmacodynamics processes. Anti-ulcer drugs are used to treat different types of ulcer and that may interact with another drug showing undesirable effects. GIT medications interfere with another type of medication either with at the pharmacokinetic and pharmacodynamic level. The main objective of this article is to review data regarding common Drug-drug & Drug-food interactions related to GIT medications. Data was collected from Google Scholar, PubMed, and Scopus databases, and they were reviewed for publication on drug-drug & drug-food interactions related to GIT medications. This data is very helpful for pharmacists while reviewing and analyzing prescribed medication, especially in geriatrics prescriptions.

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Common Causes and Characteristics of Adverse Drug Reactions in Older Adults: A Retrospective Study

10.21203/rs.3.rs-58795/v3 ◽

2020 ◽

Author(s):

Seong-Dae Woo ◽

Jiwon Yoon ◽

Go-Eun Doo ◽

Youjin Park ◽

Youngsoo Lee ◽

...

Keyword(s):

Older Adults ◽

Adverse Drug Reactions ◽

Drug Reactions ◽

Younger Patients ◽

Iodinated Contrast ◽

Common Causes ◽

Aging Populations ◽

Pharmacovigilance Center ◽

Inflammatory Drugs ◽

Rate Ratios

Abstract Background: Aging populations are often accompanied by comorbidity and polypharmacy, leading to increases in adverse drug reactions (ADRs). We sought to evaluate the causes and characteristics of ADRs in older Korean adults (≥65 years) in comparison to younger individuals (<65 years). Methods: Of 37,523 cases reported at a Korean pharmacovigilance center from 2011 to 2018, we reviewed 18,842 ADRs of certain or probable causality on the basis of WHO-UMC criteria. We estimated the number of ADRs per 1,000 patients exposed to the major culprit drugs, and incidence rate ratios were obtained to assess high- and low-risk medications in older adults. Results: In total, 4,152 (22.0%) ADRs were reported for 3,437 older adults (mean age, 74.6 years and 57.3% female). Tramadol (rate ratio, 1.32; 95% confidence interval [CI], 1.21-1.44; P <0.001) and fentanyl (1.49, 1.16-1.92, P =0.002) posed higher risks of ADRs in the older adults, whereas nonsteroidal anti-inflammatory drugs (NSAIDs) (0.35, 0.30-0.40, P <0.001) and iodinated contrast media (ICM) (0.82, 0.76-0.89, P <0.001) posed lower risks. Ratios of serious ADRs to NSAIDs (odds ratio, 2.16; 95% CI, 1.48-3.15; P <0.001) and ICM (2.09, 1.36-3.21, P= 0.001) were higher in the older adults than in the younger patients. Analgesics primarily elicited cutaneous ADRs in the younger patients and gastrointestinal reactions in the older adults. ICM more commonly led to anaphylaxis in the older adults than the younger patients (3.0% vs. 1.6%, P =0.019). Conclusion: For early detection of ADRs in older adults, better understanding of differences in the causes and characteristics thereof in comparison to the general population is needed.

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