Medication Therapy Management in Hospitalized Elderly Patients

A Focus on OTC Agents

Lynn Chan, PharmD; Philip J. Gregory, PharmD, MS, FACN; Lee E. Morrow, MD, MSc, FCCP; Mark A Malesker, PharmD, FCCP, FCCP, FASHP, BCPS


US Pharmacist. 2016;41(10):HS16-HS21. 

In This Article

Agents With Cardiac Toxicity

The chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen in older adults has been linked with hypertension and exacerbation of heart failure. The use of ibuprofen with ASA 81 mg has the potential to interfere with antiplatelet activity of aspirin, thus increasing the risk of cardiovascular events in the elderly population.[19,20] NSAIDs should ideally not be used for prolonged periods of time in older patients. In July 2015, the FDA issued a safety communication regarding NSAIDs and the increased risk of heart attack or stroke.[21]

Hypertension can also be precipitated in certain patients with uncontrolled or unrecognized hypertension following the ingestion of sympathomimetic vasoconstrictors, including pseudoephedrine and phenylephrine.[22] Famotidine has the potential to cause QT prolongation.[23] Caution should be advised when prescription drugs that can cause a prolonged QT are concurrently used with famotidine. Individually or in combination, caffeine and pseudoephedrine can cause tachycardia.[24]