# Retrospective Analysis of Potential Adverse Drug Interactions in the Drugs Prescribed to the Elderly at a Tertiary Health Care Center in Raipur, Chhattisgarh, Central India

## TL;DR

This study analyzed drug interactions in elderly patients and found many harmful combinations that could lead to serious health issues.

## Contribution

The study identifies specific high-risk drug interactions in elderly patients at a tertiary care center in India.

## Key findings

- 156 adverse drug-drug interactions were identified, with the most in Category 'C'.
- Severe interactions included combinations like salbutamol plus carvedilol/propranolol.
- DDIs were linked to risks like bleeding, electrolyte imbalances, and reduced drug effectiveness.

## Abstract

Background

The elderly population differs from adults in having various physiological changes and multiple diseases, which demand the use of multiple medications. The practice of polypharmacy in the elderly leads to numerous harmful effects like adverse drug reactions, adverse drug-drug interactions (DDIs), poor compliance, etc.

Methodology

This study collected 295 case files of elderly patients retrospectively in the Departments of General Medicine, Cardiology and Nephrology after obtaining Institute Ethics Committee approval to look for the potential adverse DDIs with their severity according to the clinical significance.

Results and interpretation

The total number of adverse DDIs identified was 156, the maximum in Category ‘C.’ Salbutamol plus carvedilol/propranolol, ramipril plus telmisartan and ivabradine plus diltiazem were the adverse DDIs categorized under severity ‘X’. The identified DDIs were categorised according to the mechanism such as increased bleeding risk, hypokalemia, hyperkalaemia, reduced effect of drugs and increased effect of drugs.

Conclusion

Polypharmacy can lead to several adverse consequences in the elderly, of which adverse DDIs play a crucial role in harmful health outcomes. This study brings out the significance of predicting drug interactions beforehand which can reduce the risk of bleeding and other risks of hyper/hypokalaemia, hyponatremia and hypoglycaemia.