1. What are the Drug Related Neurological Disturbances in Older Outpatients and Who are at Risk: Findings from a Six-Year-Long Study in North India.
- Author
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Reddy, Jaideep, Chakrabarti, Sankha Shubra, and Kaur, Upinder
- Subjects
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DRUG side effects , *OLDER patients , *CARDIOVASCULAR agents , *CALCIUM antagonists , *OLDER people - Abstract
Background: Older people are vulnerable to drug related problems (DRPs) such as adverse drug reactions (ADRs). Neurological system is one of the commonly affected systems by ADRs in the old. However, the epidemiological details of neurological ADRs have been scarcely evaluated. The main aim of this study was to predict the incidence, patterns, outcomes, and risk factors of drug-related neurological issues in older outpatients. Methodology: This was a subgroup analysis of a six year (2015 -2021) long prospective study conducted in the geriatric outpatient department of a tertiary care hospital in North India. Individuals of = 50 years developing any DRP were enrolled. Specifically, the nervous system ADRs were identified. Outcomes in the form of hospitalization and final improvement were recorded. Patients at risk of drug induced movement disorders (DIMDs) were identified. Results: In 10400 patient registrations, 187 neurological DRPs were reported (1.8%), next only to drug-induced metabolic disturbances (n=206). Sedation (27.8%), tremor (14.2%), and vertigo (11.8%) were the three most common neurological ADRs. 36 neurological DRPs (19.2%) required hospitalization. DIMDs were observed in 47 cases (27.8% of neurological ADRs) and calcium channel blockers (CCBs) such as valproate, cinnarizine, amlodipine etc. were the common culprits. Levosulpiride was involved in 41.6% of cases of drug induced extrapyramidal symptoms. Older adults of =65 years, and patients with dementia and lung disease were respectively at 3.45, 5.76- and 3.1 times higher risk of DIMDs. Conclusion: Neurological ADRs were the second most common ADRs in older outpatients and required hospitalization in every fifth case. DIMDs were the commonest neurological ADRs and CCBs might be a common culprit. Apart from antipsychotics and valproate, vigilance is warranted for antiemetic, levosulpiride, and cardiac drugs such as amlodipine. The ethnicity-related differences among older patients towards neurological ADRs should be investigated. [ABSTRACT FROM AUTHOR]
- Published
- 2023