Here are a few important points to keep in mind when evaluating elderly patients in the ED or when prescribing a new drug:

• Adverse drug effects lead to 11% of ED visits in patients > 65
• Older patients in the ED generally take > 4 medications per day, with 13% taking > 8 medications
• 11% of elderly patients in the ED receive at least 1 inappropriate medication
• 3 medication classes account for 48% of all ED visits for adverse drug effects in the elderly: oral anticoagulants or antiplatelet meds, antidiabetic medications, and agents with a narrow therapeutic index (e.g. digoxin, phenytoin)

Pay special attention to medication lists and new prescriptions in the elderly....much more attention than with younger patients!

References

Samaras N, et al. Older patients in the emergency department: a review. Ann Emerg Med 2010;56:261-269.