Learning Objective 1: The learner will be able to know about the potential health risks derived from drug-drug interactions in an elder population under polypharmacy
Learning Objective 2: The learner will be able to know the frecuency of polypharmacy in a mexican private nursing home
Methods: Exploratory study divided in three phases: 1) Identification of patients with polypharmacy from the person's chart 2) Bibliographic research about drug-drug interactions of medications taken by each patient (source 1)and 3) Identificaction of drug interactions in Medscape's Drug Interaction Checker from medications taken by each patient (source 2)
Results: From a total of 58 persons, 72.4 % presented polypharmacy. We found some differences in the information obtained from the two sources consulted: According to source 1, 69% from the people under polypharmacy were taking medications with drug-drug interactions while according to source 2 the same variable accounts for the 54%. The most frequent interactions obtained from source 1 correspond to: glyburide + enalapril (increase in glyburide effect);clopidogrel + acetilsalicilic acid (increase in bleeding risk) and captopril + paracetamol (decreasin paracetamol effect) all the former interactions with 3 mentions. Frequent interactions reported from source 2 were:acetilsalicilic acid + oral antidiabetics (hypoglucemic effect potentiation); acetilsalicilic acid + enalapril (lowering of enalapril effect) both interactions with four mentions; whereas ACE inhibitors+ selected NSAID's (lowering antihypertensive effect) had three mentions.
Conclusion: Polypharmacy was identifyed in three quarters of the population studied. From all that persons under polypharmacy, almost seventy percent showed, according to literature, potentially harmful drug-drug interactions, different figure from the on-line source. Most frequent interactions obtained from both sources correspond to drugs that do not present serious adverse reactions when administered as a single therapy. All health professionals must be aware that polypharmacy is a condition that may result in some fatal consequences, especially in the elderly. More pharmacoepidemiological studies are necessary for elucidating drug combinations that are directly related with mortality.
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