Adverse effects of high anticholinergic and sedative load in elderly patients

Authors

  • Antonio Toro-Ruiz Grupo de Investigación de Atención Farmacéutica, Universidad de Granada, Facultad de Farmacia, Granada
  • Fernando Lopez-Carmona Grupo de Investigación de Atención Farmacéutica, Universidad de Granada, Facultad de Farmacia, Granada
  • Maria Jose Zarzuelo Romero Universidad de Granada, Facultad de Farmacia, Departamento de Farmacia y Tecnología Farmacéutica, Granada https://orcid.org/0000-0001-8635-8094

DOI:

https://doi.org/10.60103/phc.v26.e845

Keywords:

Anticholinergic burden, Pharmacist; Pharmacotherapy follow-up

Abstract

Increased life expectancy has led to an increase in polypharmacy, especially in elderly patients. Anticholinergic burden (AB), resulting from the administration of anticholinergic drugs, is linked to adverse effects such as falls, cognitive and physical impairment, and increased mortality. Assessment of this burden is crucial, highlighting the need to optimize treatment and consider deprescribing in cases of adverse effects. A case is presented of a 73-year-old woman on multiple medications, experiencing dizziness and wandering. After identifying a high AB, it is recommended to adjust the medication, such as changing tolterodine for mirabegron, paroxetine for mirtazapine, and reducing doses of other drugs. After 18 months of follow-up, a reduction in CA is achieved, improving symptoms and treatment safety. This case highlights the crucial role of pharmacists in detecting and resolving drug related problems in elderly patients.

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References

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Published

2024-09-19

How to Cite

Toro-Ruiz, A., Lopez-Carmona, F., & Zarzuelo Romero, M. J. (2024). Adverse effects of high anticholinergic and sedative load in elderly patients. Pharmaceutical Care España, 26. https://doi.org/10.60103/phc.v26.e845

Issue

Section

Casos clínicos