5. Safety - Does the individual have or is at risk of ADR/side effects? Does the person know what to do if they’re ill?

Process

Identify individual safety risks by checking for


Identify adverse drug effects by checking for

  • specific symptoms/laboratory markers (e.g. hypokalaemia)
  • cumulative adverse drug effects (see ADR table)
  • drugs used to treat side effects caused by other drugs

Medication Sick Day Guidance

 

Medicines to review

The table below brings together some common areas where prescribers may be able to take action. This list is not exhaustive and does not replace individual clinical judgement. For more detail see Detail by therapeutic area based on amalgamated medication assessment tool.

Please note that the table below may need to be scrolled horizontally or vertically in order to view all information, depending on your device.

 

Drugs poorly tolerated in frail adults

High-risk clinical scenarios

Digoxin (> 125 micrograms)

Benzodiazepines/z-drugs 

Antipsychotics (inc. phenothiazines)

Anticholinergics (incl. TCAs)

Combination analgesics

NSAIDs

Sulfonylureas

Cumulative Toxicity tool

Medication Sick Day Guidance

Dehydration with

- Metformin

- ACEI/ARB

- Diuretics

- NSAID

Three of NSAID, ACEI/ARB, diuretic, metformin

DMARD – no monitoring

QT interval prolongation

NSAID + CKD/CHF/CV risk

NSAID + age >65 (without PPI)

NSAID + history of peptic ulcer

NSAID + antithrombotic

Glitazone + CHF

TCA + CHF

Warfarin + macrolide/quinolone

≥2 anticholinergics (Anticholinergic Burden Tool)

Three of antipsychotic, opioid, antidepressant, gabapentinoid, benzodiazepine/z-drug

Antiplatelet + anticoagulant

Antipsychotic in dementia

Mirabegron + elevated BP

Serotonin syndrome