Adverse drug reactions in the elderly - The local scene

Elderly patients face an increased risk of adverse reactions to drugs (ADRs) because of agerelated alteration in pharmacokinetics (drug handling) and pharmacodynamics (drug response) and because of the multiple drug regimens that are likely to be prescribed for these patients. In Hong Kong, we know little of the risk factors for and the pattern of ADRs. A hospital-based study suggested that ADRs are an important cause of acute medical admission, particularly in the elderly. Hypoglycaemia and gastrointestinal haemorrhage were the two most important ADRs in those below or over the age of 60 and the drugs most commonly implicated were sulphonylureas, non-steroidal anti-inflammatory drugs (NSAIDs) and insulin. When prescribing to the elderly, a more thoughtful and individualized approach is required. Particular attention should be given to sulphonylureas, NSAIDs and insulin.

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