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Drug-Drug Interactions Among Elderly Patients Hospitalized for Drug Toxicity.

Authors :
Juurlink, David N.
Mamdani, Muhammad
Kopp, Alexander
Laupacis, Andreas
Redelmeier, Donald A.
Source :
JAMA: Journal of the American Medical Association. 4/2/2003, Vol. 289 Issue 13, p1652. 7p.
Publication Year :
2003

Abstract

Context: Drug-drug interactions are a preventable cause of morbidity and mortality, yet their consequences in the community are not well characterized. Objective: To determine whether elderly patients admitted to hospital with specific drug toxicities were likely to have been prescribed an interacting drug in the week prior to admission. Design: Three population-based, nested case-control studies. Setting: Ontario, Canada, from January 1, 1994, to December 31, 2000. Patients: All Ontario residents aged 66 years or older treated with glyburide, digoxin, or an angiotensin-converting enzyme (ACE) inhibitor. Case patients were those admitted to hospital for drug-related toxicity. Prescription records of cases were compared with those of controls (matched on age, sex, use of the same medication, and presence or absence of renal disease) for receipt of interacting medications (co-trimoxazole with glyburide, clarithromycin with digoxin, and potassium-sparing diuretics with ACE inhibitors). Main Outcome Measure: Odds ratio for association between hospital admission for drug toxicity (hypoglycemia, digoxin toxicity, or hyperkalemia, respectively) and use of an interacting medication in the preceding week, adjusted for diagnoses, receipt of other medications, the number of prescription drugs, and the number of hospital admissions in the year preceding the index date. Results: During the 7-year study period, 909 elderly patients receiving glyburide were admitted with a diagnosis of hypoglycemia. In the primary analysis, those patients admitted for hypoglycemia were more than 6 times as likely to have been treated with co-trimoxazole in the previous week (adjusted odds ratio, 6.6; 95% confidence interval, 4.5-9.7). Patients admitted with digoxin toxicity (n = 1051) were about 12 times more likely to have been treated with clarithromycin (adjusted odds ratio, 11.7; 95% confidence interval, 7.5-18.2) in the previous week, and patients treated with ACE inhibitors admitted... [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00987484
Volume :
289
Issue :
13
Database :
Academic Search Index
Journal :
JAMA: Journal of the American Medical Association
Publication Type :
Academic Journal
Accession number :
9421915
Full Text :
https://doi.org/10.1001/jama.289.13.1652