Common Drug Side Effects and Drug‐Drug Interactions in Elderly Adults in Primary Care

Merel, Susan E.; Paauw, Douglas S.

doi:10.1111/jgs.14870

Cited by 30 publications

(14 citation statements)

References 46 publications

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“…Of the most commonly used prescription and over-the-counter drugs in the US for older adults [64], many are known to cause mitochondrial toxicity such as the cholesterol lowering drugs (Zocor, Lipitor, Pravacol, Crestor), pain medication (Aspirin, Tylenol, Aleve) and heartburn medication (Prilosec). Table 2 lists references for mitochondrial dysfunction reported for these prescription and over-the-counter (OTC) medications.…”

Section: Polypharmacy In the Geriatric Populationmentioning

confidence: 99%

“…It has been reported that elderly patients taking cholesterol lowering drugs (Zocor, Lipitor, etc.) have shown drug–drug interactions (DDI), particularly with the anti-lipidemic drug Lopid (gemfibrozil [53,106]), but also with certain antibiotic classes, such as macrolides [107,108] and fluoroquinolones [109,110] and the heart medication, Nexteron (amiodarone) [64,111]. All of these drugs have been shown to cause mitochondrial toxicity by targeting a variety of, as well as multiple, mitochondrial mechanisms/targets.…”

Section: Polypharmacy In the Geriatric Populationmentioning

confidence: 99%

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Drug-Induced Mitochondrial Toxicity in the Geriatric Population: Challenges and Future Directions

Will¹,

Shields²,

Wallace

2019

Biology

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Mitochondrial function declines with age, leading to a variety of age-related diseases (metabolic, central nervous system-related, cancer, etc.) and medication usage increases with age due to the increase in diseases. Drug-induced mitochondrial toxicity has been described for many different drug classes and can lead to liver, muscle, kidney and central nervous system injury and, in rare cases, to death. Many of the most prescribed medications in the geriatric population carry mitochondrial liabilities. We have demonstrated that, over the past decade, each class of drugs that demonstrated mitochondrial toxicity contained drugs with both more and less adverse effects on mitochondria. As patient treatment is often essential, we suggest using medication(s) with the best safety profile and the avoidance of concurrent usage of multiple medications that carry mitochondrial liabilities. In addition, we also recommend lifestyle changes to further improve one’s mitochondrial function, such as weight loss, exercise and nutrition.

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Section: Polypharmacy In the Geriatric Populationmentioning

confidence: 99%

Section: Polypharmacy In the Geriatric Populationmentioning

confidence: 99%

Drug-Induced Mitochondrial Toxicity in the Geriatric Population: Challenges and Future Directions

Will¹,

Shields²,

Wallace

2019

Biology

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“…Polypharmacy, defi ned as taking more than 5 medications, is associated with an increased risk of adverse drug events, falls, fractures, decreased adherence, and "prescribing cascade"-prescribing more drugs to treat side effects of the fi rst drug (eg, adding hypertensive medications to treat hypertension induced by If a statin will be the 20th pill, it may be less benefi cial than if it is the fi fth pill ORKABY AND COLLEAGUES nonsteroidal anti-infl ammatory drugs). 60 This is particularly important when considering adding additional medications. If a statin will be the 20th pill, it may be less benefi cial and more likely to lead to additional adverse effects than if it is the fi fth medication.…”

Section: ■ Special Considerationsmentioning

confidence: 99%

Preventing cardiovascular disease in older adults: One size does not fit all

Orkaby

Onuma

Qazi

et al. 2018

CCJM

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“…A full list of interactions can be found in resources, such as the Australian Medicines Handbook [ 21 ] but the cardiovascular drugs known to interact with warfarin include amiodarone, fibrates, and statins. Statins and warfarin are amongst the most commonly prescribed prescription medications and may be involved in both pharmacokinetic interactions and an increased risk of adverse effects [ 22 ]. However, there have been conflicting reports on the risks associated with this combination, particularly regarding warfarin control and bleed risk.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Statin Administration Does Not Affect Warfarin Time in Therapeutic Range in Australia or Singapore

Bernaitis

Ching

Teo

et al. 2018

JCM

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Background: Warfarin requires ongoing monitoring of the International Normalised Ratio (INR). This is because numerous factors influence the response, including drug interactions with commonly-prescribed medications, such as statins. The administration of statins with warfarin may change INR; however, there is limited information regarding the effects on warfarin control as measured by time in therapeutic range (TTR). Statins may also alter bleeds with warfarin, but there are conflicting reports demonstrating both increased and decreased bleeds, and limited data on diverse ethnic populations. Therefore, the aim of this study was to determine the effect of statin administration on warfarin control and bleeds in patients in Australia and Singapore. Methods: Retrospective data were collected for patients on warfarin between January and June 2014 in Australia and Singapore. Patient data were used to calculate TTR and bleed events. Concurrent statin therapy was assessed and comparisons of TTR and bleed incidence were made across patient subgroups. Results: Warfarin control in Australia and Singapore was not significantly affected by statins, as measured by TTR (83% and 58%, respectively), frequency of testing, and warfarin doses. In Australia, statin use did not significantly affect bleeds, whilst in Singapore the bleed incidence was significantly lower for patients on statins. Conclusions: Chronic concurrent administration of statins with warfarin does not adversely affect warfarin TTR in Australia or Singapore. In Singapore, patients on statins, compared to no statins, had a lower bleed incidence and this requires further investigation, especially given the potential genetic influences of ethnicity on both statin and warfarin metabolism.

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Common Drug Side Effects and Drug‐Drug Interactions in Elderly Adults in Primary Care

Cited by 30 publications

References 46 publications

Drug-Induced Mitochondrial Toxicity in the Geriatric Population: Challenges and Future Directions

Drug-Induced Mitochondrial Toxicity in the Geriatric Population: Challenges and Future Directions

Preventing cardiovascular disease in older adults: One size does not fit all

Long-Term Statin Administration Does Not Affect Warfarin Time in Therapeutic Range in Australia or Singapore

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