We already know that polypharmacy is a big issue in the elderly, but here are a few key points to keep in mind: 1. Adverse drug effects are responsible for 11% of ED visits in the elderly. 2. Almost 50% of all adverse drug effects in the elderly are accounted for by only 3 drug classes: a. oral anticoagulant or antiplatelet agents b. antidiabetic agents c. agents with narrow therapeutic index (e.g. digoxin and phenytoin) 3. 1/3 of all adverse-effect-induced ED visits are accounted for by warfarin, insulin, and digoxin. 4. Up to 20% of new prescriptions given to elderly ED patients represents a potential drug interaction.
The bottom line here is very simple--scrutinize that medication list and any new prescriptions in the elderly patient!
References
Samaras N, Chevalley T, Samaras D, et al. Older patients in the emergency department: a review. Ann Emerg Med 2010;56:261-269.
