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Clinically relevant drug-drug interactions among elderly people with dementia
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
2018 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 74, no 10, p. 1351-1360Article in journal (Refereed) Published
Abstract [en]

Purpose: Increased numbers of drugs and changes in pharmacokinetic and pharmacodynamic parameters among elderly people contribute to increased prevalence of adverse drug reactions. Drug-drug interactions (DDIs) are an important reason for admission to hospital and elderly people with dementia are particularly vulnerable. The aims of the present study were to assess the occurrence and characteristics of clinically relevant DDIs and to investigate potential risk factors associated with DDIs among elderly people with dementia.

Methods: People 65 years with dementia, admitted to two hospitals in Northern Sweden, were included. The medical records of 458 patients were reviewed. Clinically relevant DDIs were identified using the Janusmed interactions database. Pharmacological classification was conducted using Stockley's classification system.

Results: A total of 401 DDIs were identified among 43.2% of the study population, of which 98.5% had interactions that may require dose adjustment and 7.6% had drug combinations that should be avoided. Pharmacodynamic interactions were most common, of which furosemide-citalopram (n=35) were most frequently observed. Omeprazol-citalopram (n=25) was the most common drug combination among pharmacokinetic interactions. Citalopram and warfarin were the most commonly involved drug substances. An association was found between a higher number of medications being prescribed and having at least one DDI.

Conclusion: Clinically relevant drug-drug interactions are prevalent among elderly people with dementia living in Northern Sweden. Drug-drug interactions should be identified in order to manage and prevent adverse outcomes. This is particularly important among this group of people especially when multiple medications are being prescribed.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2018. Vol. 74, no 10, p. 1351-1360
Keywords [en]
Drug-drug interactions (DDIs), Drug-related problems (DRPs), Adverse drug reactions (ADRs), Adverse drug events (ADEs), Elderly people, Dementia
National Category
Pharmacology and Toxicology
Identifiers
URN: urn:nbn:se:umu:diva-152244DOI: 10.1007/s00228-018-2514-5ISI: 000444387700015PubMedID: 29967921OAI: oai:DiVA.org:umu-152244DiVA, id: diva2:1253319
Funder
The Dementia Association - The National Association for the Rights of the DementedVästerbotten County CouncilSwedish Society of MedicineAvailable from: 2018-10-04 Created: 2018-10-04 Last updated: 2018-10-04Bibliographically approved

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Sönnerstam, EvaSjölander, MariaLövheim, HugoGustafsson, Maria

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