Adverse drug reactions in patients with gastroenterological diseases: doesage increase the risk?

Citation
H. Dormann et al., Adverse drug reactions in patients with gastroenterological diseases: doesage increase the risk?, ALIM PHARM, 15(2), 2001, pp. 171-180
Citations number
43
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology,"da verificare
Journal title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN journal
0269-2813 → ACNP
Volume
15
Issue
2
Year of publication
2001
Pages
171 - 180
Database
ISI
SICI code
0269-2813(200102)15:2<171:ADRIPW>2.0.ZU;2-7
Abstract
Background: It has been claimed that the risk of adverse drug reactions inc reases with age. However, only limited data exist for disease-group specifi c risks and none for patients with liver and gastrointestinal diseases. Aims: To determine the incidence and characteristics of adverse drug reacti ons and the physicians' awareness of adverse drug reactions. Methods: During a 7-month period, a prospective survey of 532 male patients (158 aged 65 years or older; 30%) was conducted on a hepatogastroenterolog ical ward of a tertiary-care university hospital, using intensive bedside a nd computer-assisted drug surveillance methods. Results: No difference was found in the overall rate of adverse drug reacti ons between older and younger patients (25.9% vs. 24.2%) during 6213 treatm ent days. However, a significantly higher risk for developing adverse drug reactions could be shown for the elderly with biliary tract diseases (P < 0 .01). Independently of age, patients suffering from gastric ulcers, acute e pisodes of pancreatitis, cholangitis or inflammatory bowel diseases were at high risk of adverse drug reactions. Adverse drug reaction-associated mort ality was encountered in four elderly and none of the younger patients. Sec ondary pharmacological effects and drug toxicity were the main types of adv erse drug reactions for both age groups. Although 75.3% of the adverse drug reactions were predictable, only 37.5% of all adverse drug reactions were recognized by the staff physicians. conclusion: In hepatogastroenterological patients, advancing age was not as sociated with an overall increased risk of adverse drug reactions except fo r patients with biliary tract diseases. In the elderly, adverse drug reacti ons were more severe and carried higher mortality. Guidelines and education al programs should be developed to increase the awareness of adverse drug r eactions and their prevention, especially in high risk patients and, thus, to improve patient outcomes.