ABSTRACT
Background: The presence of multiple comorbidities makes prescription of multiple drugs essential in the elderly. Thisis attended with an increased risk of potential drug-drug interactions (DDIs). Aim and objectives: To determine the number of DDIs, their severity, and the common DDIs detected in the prescriptions written for elderly patients of a tertiary care teaching hospital and identify any difference in terms of gender. Material and Methods: This was a cross-sectional study. Every prescription was screened for potential DDIs using the Lexicomp® software. The detected DDIs were classified as X, avoid combination; D, consider therapy modification; and C, monitor therapy as per the Lexicomp® criteria. Results: The data from 124 patients discharged from the General Medicine department of a tertiary care hospital were evaluated. Of these, 67.7% (82/124) were females. A total of 39 category X-DDIs, 71 category D-DDIs, and 349 category C-DDIs were seen. There was a significant positive correlation between the umber of drugs prescribed and the number of DDIs detected (p < 0.001). Conclusion: Our study showed that DDIs were common among elderly patients. A large number of DDIs belong to category C, which requires only monitoring of therapy. Careful planning of the treatment regimen at the time of hospital discharge can decrease the number of drugs prescribed and, thereby, the number of potential DDIs can be decreased.
ABSTRACT
Background: Cardiovascular disease (CVD) is a common health problem in the world and a major cause of premature morbidity and mortality in the elderly. Various combinations of drugs are used for the management of CVD. Hence, the present study was conducted to analyze the drug usage trends in elderly with CVDs. Methods: A retrospective cross-sectional descriptive study was conducted for a period of 6 months in an outpatient department at a tertiary care teaching hospital. The medical records of elderly (age ≥60 years) patients with CVDs were reviewed. Drug prescribed mainly for hypertension, ischemic heart disease (IHD), congestive cardiac failure (CCF) were included along with drugs used for other co-morbidities. The results were analyzed using descriptive statistics. Results: Of 234 elderly patients, 124 (53%) were males and 110 (47%) were females. Hypertension was found in 208 (88.9%) patients, 66 (28.2%) had IHD and 4 (1.7%) had CCF. Drugs used for CVDs were beta blockers (BB) (30.77%), calcium channel blockers (CCB) (39.32%), angiotensin receptor blockers (ARB) (24.36%), angiotensin converting enzyme inhibitors (ACEIs) (20.94%) and diuretics (16.67%). Nitrates were prescribed for 66 (28.20%) patients and antiplatelet agents such as aspirin and clopidogrel were prescribed in 80 (34.19%) patients. Diabetes mellitus was found in 114 (48.7%) patients, 26 (11.1%) had bronchial asthma, followed by hyperlipidemia (3.8%), arthritis (3.8%), cerebrovascular accident (1.7%), and peripheral neuropathy, retinopathy and hypothyroidism was noted in 2 (0.9%) patients each. Conclusion: Among the antihypertensive groups CCBs were the most commonly used followed by BB, ARBs and ACEIs. Among these antihypertensive agents amlodipine, losartan, atenolol and enalapril were most commonly used. Commonly used antidiabetic agents were metformin and glimepiride.