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Significant toxicity from benzodiazepines can occur in the elderly as a result of long-term use. [112] Benzodiazepines, along with antihypertensives and drugs affecting the cholinergic system, are the most common cause of drug-induced dementia affecting over 10 percent of patients attending memory clinics.
Concerns about polypharmacy include increased adverse drug reactions, drug interactions, prescribing cascade, and higher costs. [20] A prescribing cascade occurs when a person is prescribed a drug and experiences an adverse drug effect that is misinterpreted as a new medical condition, so the patient is prescribed another drug. [21]
An adverse drug reaction (ADR) is a harmful, unintended result caused by taking medication. [1]: 1.1 Adverse Drug Reaction (ADR) [2] ADRs may occur following a single dose or prolonged administration of a drug or may result from the combination of two or more drugs.
[2] [3] They emphasize deprescribing medications that are unnecessary, which helps to reduce the problems of polypharmacy, drug interactions, and adverse drug reactions, thereby improving the risk–benefit ratio of medication regimens in at-risk people. [4] The criteria are used in geriatrics clinical care to monitor and improve the quality of ...
However, combining these drugs with alcohol, opiates or tricyclic antidepressants markedly raises the toxicity. [22] [168] [169] The elderly are more sensitive to the side effects of benzodiazepines, and poisoning may even occur from their long-term use. [170]
When two drugs affect each other, it is a drug–drug interaction (DDI). The risk of a DDI increases with the number of drugs used. [1] A large share of elderly people regularly use five or more medications or supplements, with a significant risk of side-effects from drug–drug interactions. [2] Drug interactions can be of three kinds:
[2] [3] Elderly patients are often prescribed more than one drug within the same drug class, and doctors may treat the side effects of prescribed drugs with even more drugs, which can overwhelm the patient. [4]
Another drug is prescribed to treat the new condition, and an adverse drug side-effect occurs that is again mistakenly diagnosed as a new medical condition. Thus the patient is at risk of developing additional adverse effects. [1] The most frequent medical intervention performed by a doctor is the writing of a prescription.