Assessment of Use of Drugs at Elderly With out-of Hospital Pneumonia

Abstract

One of the most important tasks of Clinical Pharmacology - strict adherence to the principles of Rational use of drugs in geriatrics to increase the efficiency and safety of pharmacotherapy. The purpose of research - pharmacoepidemiology drugs in the elderly. -Retrospective pharmacoepidemiological. Analysis of medical history data 632 elderly patients with out-of hospital pneumonia. Assessment indicators: the interaction effect of drugs, impact on efficacy and safety, risks of clinically significant interaction effects. Valuation techniques using reference sources - Swedish Physicians Desk Reference, Beers Criteria, The American Geriatric Association. 33.5% of patients receiving drug potentially recommended list Beers, of which 24.5% with a high security risk. 632 patients treated with 414 drug combinations, drug interactions safety profile analysis demonstrates their irrationality. Most often – 29.2% of the drug combination found cephalosporins+NSAIDs. In 107 cases, we used a combination of ceftriaxone+ furosemide, which enhances the nephrotoxic effects of cephalosporins. The 1.8% (3) simultaneously combined drugs of the group of cephalosporins, aminoglycosides plus furosemide, each of which has nephrotoxicity and ototoxic action. 3% of the drug combinations include the fluoroquinolones + NSAIDs, trombokard + levofloxacin that increase the risk of central nervous system excitation and convulsions. Total of 72 combinations of drugs have been reported which comprises a drug-type “C”. Potentially clinically significant drug interactions have been - 22 furosemide + enalapril, 34 digoxin+furosemide, 16 digoxin + spironolactone. Inclusion of drugs “type C” the combination increases the risk of potentially clinically significant adverse drug reactions, for the prevention of which may require dose adjustment. The pharmacotherapy of elderly is characterized by the high level (76,1%) of an irrational combination of drugs, frequent appointment (33,5%) of the drugs which aren’t recommended elderly, not compliance of clinical need in case of VP (18%) that leads to decrease in efficiency and safety of therapy.