3 Common Drugs Trigger Most ER Visits by Seniors

3 Common Drugs Trigger Most ER Visits by Seniors
TUESDAY, Dec. 4 (HealthDay News) -- Side effects from just three drugsare responsible for a full third of all U.S. emergency room visits bysenior citizens who had adverse reactions to medications, a new studyfound.
In 2004 and 2005, the blood thinner warfarin, the diabetes drug insulinand the heart drug digoxin caused about 58,000 emergency room visits ayear in those 65 and older, the researchers found.
The major problem is that it's hard to determine the correct dose foreach drug, said study lead author Dr. Daniel Budnitz, a medical officerwith the U.S. Centers for Disease Control and Prevention (CDC).
"It's challenging," he said, "and it takes work between the patient andphysician to get the dose just right."
Budnitz and his colleagues undertook the study to determine the dangerposed to senor citizens by a long list of drugs that have been deemed"potentially inappropriate" for use in the elderly.
The researchers looked at several surveys of emergency room visits from2004 and 2005. The study findings are published in the Dec. 4 issue of theAnnals of Internal Medicine.
Forty-one drugs are on the list -- called the BEERS criteria -- ofmedications considered inappropriate for the elderly. But they accountedfor just 3.6 percent of a total of about 177,000 annual emergency roomvisits.
Warfarin (also known as Coumadin), insulin and digoxin (which has anumber of trade names) posed many more problems. (Digoxin is also on thelist of potentially inappropriate drugs for the elderly, but it's onlylisted as a potential problem if taken in certain situations.)
All three medications are well-known, commonly used drugs and all cancreate problems in some cases.
Warfarin, often prescribed to heart patients, prevents blood clots bythinning the blood, but can cause excessive bleeding if the blood becomestoo thin. Insulin treats diabetes but can sometimes cause blood sugarlevels to drop to dangerous levels. And digoxin, a long-used drug, cancause a variety of problems from nausea to erratic heartbeats.
In some cases, there aren't good alternatives to these three drugs,although some doctors consider digoxin to have outlived its usefulness,the study authors noted.
Doctors can monitor the levels of all three drugs with blood tests,Budnitz said. Simple finger-prick blood tests allow testing of blood sugarlevels, and similar tests measuring clotting ability are now available insome clinics for people taking warfarin, he said.
The study results are "a reminder that doctors and patients need towork on doing the best job we can managing these medicines," Budnitz said."The answer isn't to take away medications."
Dr. Knight Steel, head of geriatric medicine at Hackensack UniversityMedical Center in New Jersey, said the study results aren't reallysurprising. Doctors have long known the risks of the three drugs inquestion, he said, adding that the research doesn't provide any newinformation.