Adverse drug reactions

Adverse drug reactions (ADRs)are the 4th-6th leading cause of death. However, up to half of these are preventable, with mis-dosing the most common error.

10-20% of hospital admissions of seniors are because of ADRs. 10-25% of community-dwelling seniors experience side-effects from meds, and this number increases to over 50% of nursing home patients.

 

Over 1:9 visits to the emergency department are due to ADRs (Zed et al, CMAJ, 2008)

 

ADRs in the elderly

"Start low, go slow"

Adverse drug reactions are more common in the elderly for a number of reasons:

Overlooking ADR's

ADRs can be overlooked, especially in the elderly, due to:

Common ADR's

Medications and Pregnancy?

There is not a black and white answer to the question "is this medicine safe for my baby"

There is good evidence of safety with TCAs, fluoxetine, sertraline, paroxetine, and citalopram. There are still more questions with venlafaxine, buproprion, and mirtazapine.

There is evidence that interpersonal psychotherapy is just as effective as medications.

 

Teratogens are especially important before 15-20 weeks gestation

There can also be obstetrical complications

Toxicity reactions around delivery

Learning and behavioural change in infancy and adulthood