[Oral anticoagulation and risk of bleeding in elderly patients - the aspect of polypharmacy].
Oral anticoagulant therapy has been shown to be of benefit also in elderly patients in various therapeutic and prophylactic indications. Despite strong evidence in literature, doctors still refuse to prescribe oral anticoagulants to geriatric patients in daily routine. Main reason for this decision is the fear of secondary bleeding complications. According to clinical trial data, distinct risk factors for bleeding attributed to anticoagulant treatment may be determined: age >70 years, female gender, recurrent bleeding events, alcohol/drug abuse, diabetes, anaemia and polypharmacy. The entire article reveals the literature in Medline and Cochrane Library from 1980 to 2009 including the hits "polypharmacy - anticoagulant treatment - elderly patients". It further highlights risk assessment strategies in elderly patients, and possible pharmacokinetic and -dynamic interactions of drugs co-administered with oral anticoagulants.
Roller
Regina E
RE
Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Austria. regina.roller-wirnsberger@meduni-graz.at.
Iglseder
Bernhard
B
Universitätsklinik für Geriatrie, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
Dovjak
Peter
P
Abteilung für Akutgeriatrie/Remobilisation, Landeskrankenhaus Gmunden, Gmunden, Austria.
Lechleitner
Monika
M
Abteilung für Innere Medizin und Akutgeriatrie, Landeskrankenhaus Hochzirl, Zirl, Austria.
Sommeregger
Ulrike
U
Abteilung für Akutgeriatrie, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Wien, Austria.
Benvenuti-Falger
Ursula
U
Abteilung für Innere Medizin und Akutgeriatrie, Landeskrankenhaus Hochzirl, Zirl, Austria.
Otto
Ronald
R
Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Austria.
Böhmdorfer
Birgit
B
Abteilung für Akutgeriatrie, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Wien, Austria.
Gosch
Markus
M
Abteilung für Innere Medizin und Akutgeriatrie, Landeskrankenhaus Hochzirl, Zirl, Austria.
D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D016330:Frail Elderly; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D012008:Recurrence; D012307:Risk Factors
D000925:Anticoagulants