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| Refrigerator Magnets of Heavily Promoted Drugs |
When I was an intern, I read in a pocketbook (my
coat pockets were overflowing with guides and manuals in those halcyon days)
called Drug Prescribing in Renal Failure that in elderly patients, 65% of
hospital admissions are caused by or contributed to by an adverse drug
reaction. At first blush, this seems like a gross overestimation (like the 100,000 deaths per year from medical errors which probably IS a gross overestimation), but
experience bears out this wisdom. As the number of drugs increases, so
does the potential for interactions and side effects - multiplicatively.
There are two related practical implications of this observation.
First, it is my practice when admitting a
patient to the ICU or hospital to stop all nonessential medications. This
includes outpatient medications and many medications begun by other physicians
during the admission. It would include medications such as:
