ASSESSMENT OF THE RISK OF ADVERSE DRUG REACTIONSIN ELDERLY PATIENTS WITH CARDIOVASCULAR DISEASE

Abstract

Relevance: International research shows that polypharmacy is common among older people. Most older people take
more than five drugs, some of which are not medically necessary. Research has clearly established a strong link between polypharmacy and negative clinical consequences. The result of polypharmacy is unwanted drug reactions, an increase in
drug side effects and drug-drug interactions. To improve the pharmacotherapy of older people, it is important to use the tools
for rationalizing drug treatment. One of them is Beers criteria.
Objective of the study: To optimize pharmacotherapy for patients of the older age group by identifying unwanted and
potentially dangerous drugs using Beers criteria.
Materials and research methods. Retrospective analysis of medical records of inpatients of patients aged 65 years and
older with cardiac profile for the period from January to December 2017.
Results of the study: As a result of the analysis of the case histories of the cardiological hospital, excessive
polypharmacy was revealed - the appointment of 10 or more drugs in 43 (40.9%) patients. Of the unwanted drugs from
Bierce's criteria, selective COX-2 inhibitors were used most of all - 18.1% of cases, ketorolac was prescribed least of all -
1.0%. Among the drugs that aggravate heart failure, NSAIDs and nondihydropyridine CCBs were prescribed. Medicines that
are potentially dangerous for the elderly are vasodilators - 100.0% and diuretics - 93.4%, to a lesser extent - carbamazepine
- 4.8% of cases. Undesirable drug combinations were noticed: warfarin + amiodarone - 1.0%, warfarin + meloxicam - 1.0%.
Of the drugs to be avoided in renal failure, spironolactone was found in 1.0% of cases.
Conclusions: The results of this study indicate the need for careful monitoring of the efficacy and safety of drug therapy.
It is necessary to apply various methods to combat polypharmacy and unwanted drug reactions, in particular, Beers criteria.
Various trainings and master classes for training doctors will help to establish pharmacotherapy for patients.