Four Common Drugs Send Thousands Of Older People In Hospital

About 100,000 older Americans are hospitalized for adverse events per year, and most of these emergencies come from four common drugs, according to new research.

The four types of drugs - two for diabetes and two blood-thinning agents - two-thirds of emergency admissions related to drugs.

"Among the thousands of drugs available for older patients, caused a small group of anticoagulants and drugs for diabetes, a high proportion of emergency admissions for adverse events among older Americans," said the study author Dr. Daniel Budnitz, director of US Centers for Disease Control and Prevention program of drug safety.

Drugs previously designated as "high risk" were involved in only 1.2 percent of the hospitals, the study found.

Working with a nationally representative database, the CDC researchers identified over 5000 cases of drug-related adverse events that have occurred in people over 65 years, from 2007 to 2009 and used this to estimate the population.



Nearly half (48 percent) of hospitalizations occurred among adults and up to 80, according to the study, published in the November 24 The New England Journal of Medicine. Almost two thirds (66 percent) were the result of an accidental overdose.

The four drugs used alone or together, most often cited:

Blood-thinning drugs warfarin (Coumadin, Jantoven), which is treated with blood clotting, has been involved in 33 percent of first aid.

Insulin is used to control blood sugar in diabetic patients, was involved in 14 percent of cases.

Antiplatelet agents such as aspirin and clopidogrel (Plavix), which is used to prevent blood clots, were involved in 13 percent of cases.

Oral anti - diabetic medicine taken by mouth - was involved in 11 percent of cases.

Anticoagulants or antiplatelet drug, the bleeding was the main problem. Of insulin and other diabetes drugs, about two-thirds of the cases involved mental status changes such as confusion, loss of consciousness or seizures.

"These results are important," said Dr. Michael Steinman, associate professor of medicine in the division of geriatrics at the University of California, San Francisco, who is familiar with the research. "This study highlights some important issues are important for physicians and patients to be aware. The first is that serious adverse reactions to drugs are common in the elderly, especially among people over 80 years. But even those 65 and older people is a significant risk of having a negative effect of their medication. "

A challenge for physicians and patients that the drug may be necessary, said Budnitz.

"These drugs are often vital to the health of patients," he said. "Patients who have these drugs should tell all the doctors what to take and work with their doctors and pharmacies to ensure that they take these drugs properly."

Among U.S. adults more than 65 years, 40 percent from five to nine drugs and 18 percent to 10 or more, according to the authors of the study. Previous research has found that older adults are nearly seven times more likely than younger to have an adverse event requiring hospitalization. "As most people age, there are often changes in the shape of their kidneys, liver, heart and other organs of work that can make them more susceptible to adverse drug reactions," said Budnitz.

And if you take pills raises many security issues, 82 percent of the physician attributed the overdose of a single drug, Budnitz said.

To reduce risk, Steinman said that doctors and patients should discuss whether the medication is really necessary. For people with high blood pressure or blood sugar, "the answer is almost always" yes ", you must treat it," said Steinman. "But if you have high blood pressure or blood sugar slightly, the benefits to look at in relation to the damage begins to change. These drugs are really provide enough benefit, it is worth taking them? "

Physicians and patients should consider a person's age, general health, other medications they take (keep a list including dosages) and patient preferences such as how easy they are to keep track blood glucose and dosages, he said.

With blood thinners or anticoagulants, stopping is probably not an option, said Steinman. Thus, patients must adapt to all the side effects they experience, even if they seem minor. Capture the side effects can often prevent more serious problems in the future, physicians may be able to change the medication or lower doses, he said.