title: [Adverse drug reactions in three older patients, even without changes in medication].
abstract: Two women, aged 77 and 73 years, and one man, aged 71 years, were admitted because of a serious adverse drug reaction (ADR). The first woman had a probable adverse drug reaction caused by digoxin after the addition of a NSAID (diclofenac) to a combination of digoxin and other drugs (furosemide and hydroquinine). The ADR due to digoxin is an example of a pharmacokinetic interaction. The second woman had serious orthostatic hypotension because of a pharmacodynamic interaction between three different antihypertensives. In the man, the ADR was hypoglycaemia while taking glibenclamide, a second generation sulfonylurea derivative. This was probably caused by declining renal function of a transplanted kidney because of bladder cancer. Doctors should be aware of ADRs in older patients, which also can occur when no changes in medication have taken place. In old age, any decline in vitality or function can be due to an ADR.
authors.affiliation: Albert Schweitzer Ziekenhuis, locatie Dordwijk, Vakgroep Klinische Geriatrie, Postbus 306, 3300 AH Dordrecht. c.k.mannesse@dszh.nl
authors.forename: C K
authors.initials: CK
authors.lastname: Mannesse
authors.forename: T J M
authors.initials: TJ
authors.lastname: van der Cammen
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000009:adverse effects*; D004008:Diclofenac / Q000494:pharmacology; D004077:Digoxin / Q000009:adverse effects* / Q000493:pharmacokinetics; D004232:Diuretics / Q000008:administration & dosage; D004347:Drug Interactions; D005260:Female; D005665:Furosemide / Q000008:administration & dosage; D005905:Glyburide / Q000009:adverse effects; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007024:Hypotension, Orthostatic / Q000139:chemically induced*; D007668:Kidney / Q000503:physiopathology; D008297:Male; D011802:Quinidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology
chemical_list: D000889:Anti-Arrhythmia Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000959:Antihypertensive Agents; D004232:Diuretics; D007004:Hypoglycemic Agents; D004008:Diclofenac; D004077:Digoxin; D005665:Furosemide; C014486:hydroquinidine; D011802:Quinidine; D005905:Glyburide
vernacular_title: Bijwerkingen van geneesmiddelen bij 3 oudere patiënten: ook bij ongewijzigd medicatiegebruik.