Drug-disease interactions

Obtain a complete medical and social history, identifying any potential drug-disease interactions or social factors that may influence treatment choices. 

What prescription and over-the-counter medications should be avoided to prevent drug-drug, drug-food, or drug-disease interactions ... 

Table 2.3 Examples of common drug-disease interactions...

Because of the frequent co-existence of multiple disease and polypharmacy, the potential for drug disease interactions is an extremely important aspect of drug therapy in older patients. Hepatic and renal disease, by altering drug clearance, can affect dose requirements. Other diseases leave the patient at risk of significant adverse effects (Table 4). The prescriber... 

Table 4. Important drug-disease interactions in older persons...

Table 7 Some important drug-disease interactions in older patients... 

Kulmatycki KM, Jamah F. Drug disease interactions role of inflammatory mediators in disease and variability in drug response. J Pharrn Pharmaceut Sci 2005 16 602-25. 

In liver disease, the likelihood of a pharmacoki-netically relevant drug-disease interaction depends on the type of drug (extent of intra-/extra-hepatic elimination, hepatic extraction ratio, protein binding) and the nature (flow, enzymatic capacity/reserve) and extent of the liver dysfunction. The likelihood of... 

Analysis of response in subsets of the overall population drug-demographic, drug-drug, and drug-disease interactions... 

Drug-Demographic and Drug-Disease Interactions. The information from pharmacokinetic and pharmacodynamic studies as well as clinical trials should be analyzed in the same way as were done to determine drug-drug interactions. 

A. L. Parke, C. loannides, D. F. V. Lewis, and D. V. Parke, Inflammopharmacology, 1, 3 (1991). Molecular Pathology of Drug—Disease Interactions in Chronic Autoimmune Inflammatory Diseases. 

Brater DC. Drug-drug and drug-disease interactions with nonsteroidal anti-inflammatory drugs. Am J Med 1986 80(lA) 62-77. 

The Beers criteria were updated recently/ At present, it is not clear what is the best way to measure inappropriate prescribing. Global measures for detecting polypharmacy or unnecessary drug use and underuse of essential medications are needed, as well as additional studies examining drug-disease interactions and other health outcomes. Moreover, we recommend further studies of the predictive validity of evidence-based standards for measuring inappropriate medications in the elderly. 

---