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Cited by 761

The DOI matches its Crossref record; 7 of the 7 references it cites were found in a registry or an index.

Drug-Drug Interactions Among Elderly Patients Hospitalized for Drug Toxicity

Juurlink, David N., Mamdani, Muhammad, Kopp, Alexander, Laupacis, Andreas, Redelmeier, Donald A.·2003·JAMA
DOI 10.1001/jama.289.13.1652
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Abstract

Context: Drug-drug interactions are a preventable cause of morbidity and mortality, yet their consequences in the community are not well characterized. Objective: To determine whether elderly patients admitted to hospital with specific drug toxicities were likely to have been prescribed an interacting drug in the week prior to admission. Design: Three population-based, nested case-control studies. Setting: Ontario, Canada, from January 1, 1994, to December 31, 2000. Patients: All Ontario residents aged 66 years or older treated with glyburide, digoxin, or an angiotensin-converting enzyme (ACE) inhibitor. Case patients were those admitted to hospital for drug-related toxicity. Prescription records of cases were compared with those of controls (matched on age, sex, use of the same medication, and presence or absence of renal disease) for receipt of interacting medications (co-trimoxazole with glyburide, clarithromycin with digoxin, and potassium-sparing diuretics with ACE inhibitors). Main Outcome Measure: Odds ratio for association between hospital admission for drug toxicity (hypoglycemia, digoxin toxicity, or hyperkalemia, respectively) and use of an interacting medication in the preceding week, adjusted for diagnoses, receipt of other medications, the number of prescription drugs, and the number of hospital admissions in the year preceding the index date. Results: During the 7-year study period, 909 elderly patients receiving glyburide were admitted with a diagnosis of hypoglycemia. In the primary analysis, those patients admitted for hypoglycemia were more than 6 times as likely to have been treated with co-trimoxazole in the previous week (adjusted odds ratio, 6.6; 95% confidence interval, 4.5-9.7). Patients admitted with digoxin toxicity (n = 1051) were about 12 times more likely to have been treated with clarithromycin (adjusted odds ratio, 11.7; 95% confidence interval, 7.5-18.2) in the previous week, and patients treated with ACE inhibitors admitted with a diagnosis of hyperkalemia (n = 523) were about 20 times more likely to have been treated with a potassium-sparing diuretic (adjusted odds ratio, 20.3; 95% confidence interval, 13.4-30.7) in the previous week. No increased risk of drug toxicity was found for drugs with similar indications but no known interactions (amoxicillin, cefuroxime, and indapamide, respectively). Conclusions: Many hospital admissions of elderly patients for drug toxicity occur after administration of a drug known to cause drug-drug interactions. Many of these interactions could have been avoided.

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Metadata

Authors
Juurlink, D. N., Mamdani, M., Kopp, A., Laupacis, A., & Redelmeier, D. A.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2003-04-02
Volume
289
Issue
13
Pages
1652
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.289.13.1652
OpenAlex
W2061075125
Cited by
761
References
7
FWCI
18.13
Type
journal article
Language
en
Open access
closed

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