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The Chief Adverse Effects of Medications

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On-Call Geriatric Psychiatry

Abstract

A significant number of requests for on-call geriatric psychiatric consultation will pertain to management of side effects of psychotropic and systemic medications. Many factors converge to make this area an important one, including ubiquitous polypharmacy in older patients, their vulnerability to medication-associated syndromes, and the need to account for drug metabolic changes in older patients leading to more cautious and conservative prescribing practices. The authors review these and other topics pertinent to avoiding and managing significant medication side effects when managing medications in an on-call paradigm.

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References

  1. Gnjidic D, Hilmer SN, Blyth FM, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol. 2012;65(9):989–95.

    Article  PubMed  Google Scholar 

  2. Hanlon JT, Pieper CF, Hajjar ER, et al. Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay. J Gerontol A Biol Sci Med Sci. 2006;61(5):511–5.

    Article  PubMed  Google Scholar 

  3. Obreli Neto PR, Nobili A, de Lyra Jr DP, et al. Incidence and predictors of adverse drug reactions caused by drug-drug interactions in elderly outpatients: a prospective cohort study. J Pharm Pharm Sci. 2012;15(2):332–43.

    CAS  PubMed  Google Scholar 

  4. Wu C, Bell CM, Wodchis WP. Incidence and economic burden of adverse drug reactions among elderly patients in Ontario emergency departments: a retrospective study. Drug Saf. 2012;35(9):769–81.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Marcum ZA, Amuan ME, Hanlon JT, et al. Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans. J Am Geriatr Soc. 2012;60(1):34–41.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Morgan TK, Williamson M, Pirotta M, Stewart K, Myers SP, Barnes J. A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older. Med J Aust. 2012;196(1):50–3.

    Article  PubMed  Google Scholar 

  7. Lin CF, Wang CY, Bai CH. Polypharmacy, aging and potential drug-drug interactions in outpatients in Taiwan: a retrospective computerized screening study. Drugs Aging. 2011;28(3):219–25.

    Article  CAS  PubMed  Google Scholar 

  8. Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002;162(20):2269–76.

    Article  PubMed  Google Scholar 

  9. Lund BC, Carnahan RM, Egge JA, Chrischilles EA, Kaboli PJ. Inappropriate prescribing predicts adverse drug events in older adults. Ann Pharmacother. 2010;44(6):957–63.

    Article  PubMed  Google Scholar 

  10. By the American Geriatrics Society Beers Criteria Update Expert P. American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227–2246.

    Google Scholar 

  11. O'Mahony D, O'Sullivan D, Byrne S, O'Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hamilton H, Gallagher P, Ryan C, Byrne S, O'Mahony D. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients. Arch Intern Med. 2011;171(11):1013–9.

    Article  PubMed  Google Scholar 

  13. GeriatricsCareOnline.org. iGeriatrics-Mobile App. 2015. http://geriatricscareonline.org/ProductAbstract/igeriatrics-mobile-app/B019/?param2=search. Accessed 6 Oct 2015.

  14. Mulsant BH, Pollock BG, Kirshner M, Shen C, Dodge H, Ganguli M. Serum anticholinergic activity in a community-based sample of older adults: relationship with cognitive performance. Arch Gen Psychiatry. 2003;60(2):198–203.

    Article  CAS  PubMed  Google Scholar 

  15. Carnahan RM, Lund BC, Perry PJ, Pollock BG, Culp KR. The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol. 2006;46(12):1481–6.

    Article  CAS  PubMed  Google Scholar 

  16. Kalisch Ellett LM, Pratt NL, Ramsay EN, Barratt JD, Roughead EE. Multiple anticholinergic medication use and risk of hospital admission for confusion or dementia. J Am Geriatr Soc. 2014;62(10):1916–22.

    Article  PubMed  Google Scholar 

  17. Gray SL, Anderson ML, Dublin S, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401–7.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Erickson SC, Le L, Zakharyan A, et al. New-onset treatment-dependent diabetes mellitus and hyperlipidemia associated with atypical antipsychotic use in older adults without schizophrenia or bipolar disorder. J Am Geriatr Soc. 2012;60(3):474–9.

    Article  PubMed  Google Scholar 

  19. Ramaswamy K, Masand PS, Nasrallah HA. Do certain atypical antipsychotics increase the risk of diabetes? A critical review of 17 pharmacoepidemiologic studies. Ann Clin Psychiatry. 2006;18(3):183–94.

    Article  PubMed  Google Scholar 

  20. Lipscombe LL, Levesque LE, Gruneir A, et al. Antipsychotic drugs and the risk of hyperglycemia in older adults without diabetes: a population-based observational study. Am J Geriatr Psychiatry. 2011;19(12):1026–33.

    Article  PubMed  Google Scholar 

  21. Bishara A, Phan SV, Young HN, Liao TV. Glucose disturbances and atypical antipsychotic use in the intensive care unit. J Pharm Pract. May 6;2015.

    Google Scholar 

  22. Rej S, Herrmann N, Shulman K. The effects of lithium on renal function in older adults – a systematic review. J Geriatr Psychiatry Neurol. 2012;25(1):51–61.

    Article  PubMed  Google Scholar 

  23. Shine B, McKnight RF, Leaver L, Geddes JR. Long-term effects of lithium on renal, thyroid, and parathyroid function: a retrospective analysis of laboratory data. Lancet. 2015;386(9992):461–8.

    Article  CAS  PubMed  Google Scholar 

  24. Juurlink DN, Mamdani MM, Kopp A, Rochon PA, Shulman KI, Redelmeier DA. Drug-induced lithium toxicity in the elderly: a population-based study. J Am Geriatr Soc. 2004;52(5):794–8.

    Article  PubMed  Google Scholar 

  25. Perry PJ, Wilborn CA. Serotonin syndrome vs neuroleptic malignant syndrome: a contrast of causes, diagnoses, and management. Ann Clin Psychiatry. 2012;24(2):155–62.

    PubMed  Google Scholar 

  26. de Abajo FJ. Effects of selective serotonin reuptake inhibitors on platelet function: mechanisms, clinical outcomes and implications for use in elderly patients. Drugs Aging. 2011;28(5):345–67.

    Article  PubMed  Google Scholar 

  27. Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005;352(11):1112–20.

    Article  CAS  PubMed  Google Scholar 

  28. Abadie D, Rousseau V, Logerot S, Cottin J, Montastruc JL, Montastruc F. Serotonin syndrome: analysis of cases registered in the French pharmacovigilance database. J Clin Psychopharmacol. 2015;35(4):382–8.

    CAS  PubMed  Google Scholar 

  29. Jhun P, Bright A, Herbert M. Serotonin syndrome and opioids – what’s the deal? Ann Emerg Med. 2015;65(4):434–5.

    Article  PubMed  Google Scholar 

  30. Douros A, Grabowksi K, Stahlmann R. Drug-drug interactions and safety of linezolid, tedizolid, and other oxazolidinones. Expert Opin Drug Metab Toxicol. 2015;1–11.

    Google Scholar 

  31. Jiang HY, Chen HZ, Hu XJ, et al. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2015;13(1):42–50.e43.

    Article  CAS  PubMed  Google Scholar 

  32. Shin D, Oh YH, Eom CS, Park SM. Use of selective serotonin reuptake inhibitors and risk of stroke: a systematic review and meta-analysis. J Neurol. 2014;261(4):686–95.

    Article  CAS  PubMed  Google Scholar 

  33. Takeuchi H, Suzuki T, Remington G, Uchida H. Antipsychotic polypharmacy and corrected QT interval: a systematic review. Can J Psychiatry. 2015;60(5):215–22.

    PubMed  PubMed Central  Google Scholar 

  34. Vieweg WV, Wood MA, Fernandez A, Beatty-Brooks M, Hasnain M, Pandurangi AK. Proarrhythmic risk with antipsychotic and antidepressant drugs: implications in the elderly. Drugs Aging. 2009;26(12):997–1012.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Division of General Medicine, University of California Davis Medical Center, Sacramento, CA, USA

    Calvin H. Hirsch MD

  2. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Shyam Maharaj BSc. Pharm, PhD

  3. Department of Psychiatry/Langley Porter Psychiatric Institute, University of California San Francisco, San Francisco, CA, USA

    James A. Bourgeois OD, MD

Authors
  1. Calvin H. Hirsch MD
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  2. Shyam Maharaj BSc. Pharm, PhD
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  3. James A. Bourgeois OD, MD
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Corresponding author

Correspondence to Calvin H. Hirsch MD .

Editor information

Editors and Affiliations

  1. Dept. of Psychiatry & Behavioural Neuros, McMaster University, Hamilton, Ontario, Canada

    Ana Hategan

  2. Dept. of Psychiatry/Langley Porter Psych, University of California San Francisco, San Francisco, New York, USA

    James A. Bourgeois

  3. Dept.of Internal Med.,Div of General Med, University of California Davis, Sacramento, California, USA

    Calvin H. Hirsch

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© 2016 Springer International Publishing Switzerland

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Hirsch, C.H., Maharaj, S., Bourgeois, J.A. (2016). The Chief Adverse Effects of Medications. In: Hategan, A., Bourgeois, J., Hirsch, C. (eds) On-Call Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-30346-8_12

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  • DOI: https://doi.org/10.1007/978-3-319-30346-8_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-30344-4

  • Online ISBN: 978-3-319-30346-8

  • eBook Packages: MedicineMedicine (R0)

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