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摘要
Aims: The aims of this study are to evaluate prevalence and characteristics of adverse drug reactions (ADRs) and to evaluate the potential contribution of specific medications, therapeutic categories and drug-drug interactions (DDIs) in older adults. %26lt;br%26gt;Methods: All ADR reporting forms of persons aged 65 + years collected by the pharmacovigilance of one of the main hospitals in Italy during 2013 were evaluated. DDIs were analysed by a computerized prescription system (INTERCheck) and based on the interactions%26apos; database managed by the Istituto di Ricerche Farmacologiche Mario Negri. DDIs were classified according to their clinical relevance as contraindicated, major, and moderate. %26lt;br%26gt;Results: Amongst all the ADR reporting forms (n = 1014) collected during 2013, 343 affected older adults. The most frequent ADRs were: haemorrhages (n = 122, 35.5%), allergic reactions (n = 56, 16.3%), and elevated International Normalized Ratio (INR %26gt; 6, n = 54, 15.7%). The specific medications that contributed to ADRs were warfarin (42.5%), acenocumarol (9%), and allopurinol (8.5%); while the therapeutic categories were haematological agents (67%) and proton pump inhibitors (13%). A total of 912 DDIs were found; one third of them were contraindicated or major and 31.5% of them potentially contributed to ADRs; of these, the most frequent were: warfarin and heparin (contraindicated, n = 5); warfarin and a statin (major, n = 38); warfarin and a proton pump inhibitor (moderate, n = 40). At least one DDI contributed to 66 haemorrhages out of 122 (54%) and to 41 elevated INR out of 54 (76%). %26lt;br%26gt;Conclusion: DDIs significantly contribute to the onset of ADRs in older adults and intervention programmes, e.g., the employment of a computerized system, may reduce the burden of iatrogenic illnesses in the elderly.
- 出版日期2014-11
