TOTALLY GEEKED!

Members Login
Username 
 
Password 
    Remember Me  
totallygeeked -> totallygeeked general -> Antipsychotic Drugs Cause Deadly Falls in Older Adults
Post Info TOPIC: Antipsychotic Drugs Cause Deadly Falls in Older Adults
ed11563


Guru

Status: Offline
Posts: 9186
Date:
Antipsychotic Drugs Cause Deadly Falls in Older Adults
Permalink  
 

 

Antipsychotic Drugs Cause Deadly Falls in Older Adults

bottomlinehealth.com/antipsychotic-drugs-cause-deadly-falls-in-older-adults/

If you have a spouse, relative or friend who is in the later stages of Alzheimer’s disease, Lewy body dementia or a neurodegenerative illness such as Parkinson’s disease, he or she is probably being given an antipsychotic drug to manage behavior problems, such as agitation and aggression, and/or psychotic symptoms. Or perhaps you are caring for a person who is aging with schizophrenia or severe bipolar disorder and is on an antipsychotic drug. The medication is as much for the person’s comfort as for the people taking care of him or her, but like all drugs, antipsychotics carry side effects. And now, researchers have confirmed that newer antipsychotic drugs, thought to be safer than the older drugs, are also associated with a particularly dangerous side effect in older adults—falls. Because antipsychotic drugs can weaken bones and cause osteoporosis and osteoporotic fractures, falls can easily be deadly in this population group.

TRIPPED UP BY A DRUG

The idea that antipsychotic medications and bone fractures go together is not entirely new—reports have periodically surfaced in the medical literature, and it is known that antipsychotics can weaken bones. But there wasn’t enough evidence to prove a direct link between osteoporotic fractures and falls and the newest class of antipsychotic drugs, called atypicals.

Enter a team of Canadian researchers from University of Western Ontario. The team reasoned that atypicals might be likely to cause falls, resulting in fractures, in older adults because they can cause orthostatic hypotension, a sudden drop in blood pressure that causes dizziness or fainting, as well as gait and coordination difficulties and sedation.

To investigate an association between atypicals, falls and fractures, the researchers studied the medical records of a total of 200,000 Ontario residents, all 65 years old or older. They honed in on patients who had received new (first-time) prescriptions for one of three atypical antipsychotic drugs—quetiapine (Seroquel), risperidone (Risperdal) or olanzapine (Zyprexa). Each person was matched with a person of the same age and gender and several dozen other characteristics, such as presence of dementia or psychotic illness, diabetes or arthritis, previous fractures or falls, use of osteoporotic drugs and whether or not they lived in a nursing facility. Patients and controls were followed for the first 90 days after the patients started on the drugs.

The results: Among patients taking atypical antipsychotics, the rate of fractures associated with osteoporosis was 7% and the rate of falls was 4.4%–and if those numbers don’t sound high to you, keep in mind that this was only in the first 90 days of taking the drugs. That’s not much time at all! And meanwhile, members of the control group of similar people who were not taking the drugs were only about half as likely to suffer osteoporotic fractures or falls.

And in terms of fall and fracture risk, it didn’t matter which atypical antipsychotic was taken or at what dosage—all three drugs and various dosages were associated with similar heightened risk.

TAKE STEPS TO PREVENT FALLS

The take-home message here is pretty clear. If a doctor has prescribed an atypical antipsychotic medication to a loved one—perhaps someone under your care or in an assisted-living environment—he is at an increased risk for falls. If you believe the drug’s overall benefits are worth its risks, even if this person has never had a history of unsteadiness or falling, consider taking steps to reduce risk of falls, such as improving the lighting and removing throw rugs in the living area of the patient and installing safety grab bars and raised toilet seats and bathtub benches in the bathroom. Caretakers also might want to speak to the patient’s doctor about physical therapy and the value of a cane or walker to reduce risk of falls.

Source: Research letter titled “Falls and Fractures with Atypical Antipsychotic Medication Use: A Population-Based Cohort Study,” from researchers at Western University, London, Ontario, published in JAMA Internal Medicine.

 

 



__________________

The Principle of Least Interest: He who cares least about a relationship, controls it.

Always misinterpret when you can.
Lady Gaga Snerd


Guru

Status: Offline
Posts: 25897
Date:
Permalink  
 

People seem to be overmedicated period.

__________________

https://politicsandstuff.proboards.com/
aergia


Regular

Status: Offline
Posts: 386
Date:
Permalink  
 

orthostatic hypotension, a sudden drop in blood pressure that causes dizziness or fainting,
any BP med, any diuretic and a host of other meds' literature will list this a a possible side effect.

It is not unique to atypical psychcotropics.

Balance may be impaired among the eldery all by itself.

And this one, must be a bad drug in infrequent use due to the side effects. Yes, Friends meet Aspirin or ASA for short: Endoscopically identifiable gastric mucosal lesions occur in most patients who receive a single dose of aspirin. Clinically evident gastrointestinal bleeding has been reported in as many as 3% of treated elderly patients. Anorectal ulceration and rectal stenosis have been reported in patients who abuse aspirin-containing rectal suppositories. One case-controlled study has suggested that an association between aspirin (and other NSAID) consumption and appendicitis may exist.

The risk of developing dyspeptic events (i.e., epigastric pain, heartburn, nausea, ulcers) is low in rheumatic patients with no prior gastrointestinal symptoms who receive low-dose (less than 650 mg/day) aspirin therapy.[Ref]

Gastrointestinal side effects have included epigastric distress (in as many as 83% of patients treated with regular aspirin), abdominal discomfort or pain, endoscopically identifiable gastric mucosal lesions, nausea, and vomiting. More serious gastrointestinal effects include hemorrhage, peptic ulcers, perforation, small bowel enteropathy, and esophageal ulcerations.[Ref]
Renal

The mechanism of an aspirin-induced decrease in renal function may be related to inhibition of renal prostaglandin synthesis with consequent decreases in renal blood flow. Vasodilating renal prostaglandins may be particularly important in patients who exhibit arterial underfilling (i.e. heart failure, cirrhosis). The administration of high doses of NSAIDs to such patients has produced acute renal failure in rare instances.[Ref]

Renal side effects have included reduction in glomerular filtration rate (particularly in patients who are sodium restricted or who exhibit diminished effective arterial blood volume, such as patients with advanced heart failure or cirrhosis), interstitial nephritis, papillary necrosis, elevations in serum creatinine, elevations in blood urea nitrogen, proteinuria, hematuria, and renal failure.[Ref]
Hematologic

Hematologic side effects have included increased blood fibrinolytic activity. In addition, hypoprothrombinemia, thrombocytopenia, thrombocyturia, megaloblastic anemia, and pancytopenia have been reported rarely. Aplastic anemia and eosinophilia have also been reported.[Ref]
Hypersensitivity

The mechanism of aspirin-induced hypersensitivity may be related to an up-regulation of the 5-lipoxygenase pathway of arachidonic acid metabolism with a resulting increase in the products of 5-lipoxygenase (such as leukotrienes).[Ref]

Hypersensitivity side effects have included bronchospasm, rhinitis, conjunctivitis, urticaria, angioedema, and anaphylaxis. Approximately 10% to 30% of asthmatics are aspirin-sensitive (with the clinical triad of aspirin sensitivity, bronchial asthma, and nasal polyps).[Ref]
Dermatologic

Dermatologic side effects have included Stevens-Johnson syndrome and a lichenoid eruption. In addition, isolated cases of unilateral aquagenic wrinkling of the palms and papuloerythroderma have been associated with aspirin therapy.[Ref]
Hepatic

Hepatic side effects have included hepatotoxicity and cholestatic hepatitis.[Ref]
Oncologic

Oncologic side effects have included reports of pancreatic cancer. Several epidemiologic studies have suggested that chronic aspirin use may decrease the risk of large bowel neoplasms. However, other studies have not found such a beneficial effect.[Ref]
Metabolic

Metabolic side effects have included dehydration and hyperkalemia. Respiratory alkalosis and metabolic acidosis, particularly during salicylate toxicity, have been reported. A case of hypoglycemia has been reported in a patient on hemodialysis. Salicylates have also been reported to displace triiodothyronine (T3) and thyroxine (T4) from protein binding sites. The initial effect is an increase in serum free T4 concentrations.[Ref]
Cardiovascular

A 29-year-old female with a history of migraine developed chest pain, tachycardia and orthopnea following aspirin consumption at doses of 1500 mg per day for several days. After discontinuation of aspirin therapy, the patient's symptoms promptly resolved. The patient consented to a pharmacological challenge test which once again triggered the symptoms.[Ref]

Cardiovascular side effects have included salicylate-induced variant angina, ventricular ectopy, conduction abnormalities, and hypotension, particularly during salicylate toxicity. In addition, at least one case of fluid retention simulating acute congestive heart failure has been reported during aspirin therapy. Antiplatelet therapy has also been associated with acute deterioration of intracerebral hemorrhage.[Ref]
Nervous system

Central nervous system side effects have included agitation, cerebral edema, coma, confusion, dizziness, headache, cranial hemorrhage, lethargy and seizures. Tinnitus and subjective hearing loss (or both) may occur. Some investigators have reported that modest doses may result in decreased frequency selectivity and may therefore impair hearing performance, particularly in the setting of background noise.[Ref]

Some investigators have suggested that tinnitus may be a less reliable indicator of salicylate toxicity than previously believed. Patients with high frequency hearing loss may have difficulty perceiving tinnitus. In a study of rheumatoid arthritis patients, those with tinnitus had no greater salicylate levels than those without tinnitus. Elderly patients may be less likely to perceive tinnitus than younger patients.[Ref]
Other

Reye's syndrome typically involves vomiting, neurologic dysfunction, and hepatic dysfunction during or shortly after an acute viral infection.[Ref]

Other side effects have included Reye's syndrome with aspirin use in children with an acute viral illness. Reye's syndrome has also been reported even more rarely in adults.[Ref]
Musculoskeletal

Musculoskeletal side effects have included rhabdomyolysis.[Ref]
Respiratory

Respiratory side effects have included hyperpnea, pulmonary edema, and tachypnea.[Ref]

Aspirin desensitization has been used to decrease disease activity and reduce the need for systemic corticosteroids in patients with aspirin-exacerbated respiratory disease.[Ref]

Endocrine

Endocrine side effects have included hypoglycemia (which has been reported in children) and hyperglycemia.[Ref]
Ocular

Ocular side effects have included cases of localized periorbital edema.[Ref]

All in all, when it applies, I still take it.



__________________

Minds are like parachutes, they work best when open
Page 1 of 1  sorted by
Quick Reply

Please log in to post quick replies.
totallygeeked -> totallygeeked general -> Antipsychotic Drugs Cause Deadly Falls in Older Adults


Create your own FREE Forum
Report Abuse 		Powered by ActiveBoard