148 / 210
S140
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
statins (26.1%). For most of the medications examined a decline in
prescription was observed among individuals aged ≥90 years.
Conclusions:
The burden of medication treatment progressively
increases till age 85 years and substantially declines after age of 90
years with an inverse U shaped relationship. Patterns of medication
prescription widely vary across age groups.
P-403
Antidepressant drugs and the risk of hyponatremia
–
a Danish
register-based cohort study
A. Højmann
1
, K.B. Leth-Møller
2
, C.T. Pedersen
3
, S.E. Andersen
4
,
L. Ødum
5
, M.B. Torstensson
6
, G. Gislason
2
, E. Holm
7
1
Køge Hospital, Næstved, Denmark;
2
Gentofte Hospital, Gentofte,
Denmark;
3
Aalborg Hospital, Aalborg, Denmark;
4
Roskilde Hospital,
Roskilde, Denmark;
5
Roskilde Hospital, Rosklde, Denmark;
6
Nykøbing
F Hospital, Nykøbing F, Denmark;
7
Denmark
Background:
Depression is a frequent and serious condition.
Drugs used for treatment have several side effects, including
hyponatremia. Hyponatremia reduces cognitive functioning and
balance, and increases mortality. Studies have shown an association
between Selective Serotonin reuptake inhibitors (SSRI) and
hyponatremia. Whether the association is similar with other
antidepressants, is less clear. The aim of this study is to increase
our knowledge of the association between different types of
antidepressants and hyponatremia.
Methods:
This is an observational Danish register-based cohort
study using nationwide registers from 1998 to 2012. The study
population consists of all individuals in The Northern Region of
Denmark. The associations between different antidepressants and
hyponatremia, and the chance of having a blood sample for sodium
taken, were analyzed using the multivariable Poisson regression
model.
Results:
There were 449,965 individuals included in the study.
Analysis showed a statistical significant increased risk of
hyponatremia for all antidepressants p
<
0.001, except for Mianserin
p = 0.12. The IRR (Incidence risk ratio) for having a p-sodium
measured was highest with Citalopram (IRR 3.1) and Mirtazapin
(IRR 3.0), lowest with Mianserin (IRR 1.7). For all antidepressants,
the IRR for hyponatremia was highest within the first 2 weeks after
initiating treatment.
Conclusion:
The study shows an increased risk of hyponatremia
for all antidepressant drugs, with a tendency of less risk with
NaSSA’s. The results may be affected by the fact, that patients
using Mianserin were less likely to have p-Sodium measured, and
thereby underestimating the risk of hyponatremia. The risk was
higher within the first weeks.
P-404
Macrolide co-prescription with statins: an Oxford University
Hospitals (OUH) NHS Trust audit
I. Haeusler
1
, M. Ali
2
, J. Reynolds
2
1
Oxford University Hospitals, Oxford, United Kingdom;
2
Oxford
University Hospitals, Oxford
Objectives:
The macrolide antibiotics erythromycin and clar-
ithromycin inhibit cytochrome p450 3A4 (CYP3A4) which is
involved in the metabolism of many commonly prescribed drugs
including simvastatin and atorvastatin. When these statins are co-
prescribed with macrolides, the serum concentration and risk of
statin toxicity increases. There is a greater risk of this occurring
in geriatric patients and patients with multiple co-morbidities.
The Medicines and Healthcare Products Regulatory Agency (MHRA)
advises against co-prescription of erythromycin and clarithromycin
with simvastatin and atorvastatin. This audit’s objective was
therefore to assess adherence to the MHRA guidance in the 1800-
bed OUH Trust.
Methods:
Electronic drug charts were used to identify patients
across the trust who had been co-prescribed a macrolide and statin
during their current admission.
Results:
68 patients (M:F 40:28) received a macrolide antibiotic
during their current admission. Mean age was 70
±
17.7 years
(range 19–96). None of the 4 patients who were prescribed
erythromycin had a concomitant statin prescription. 60 were
prescribed clarithromycin and of these, 15 were taking a statin
on admission. Of these, 5 people, with an average age of 76.4
(range 60–87), did not have the statin suspended.
Conclusions:
5 of 15 patients continued to remain on a statin when
prescribed a concomitant macrolide. With an average age of 76.4
years, this problem occurred in older people who have a higher
risk of developing statin toxicity. These findings demonstrate that
an alert to remind prescribers of this interaction on the trust’s
Electronic Prescribing system would be useful to eliminate co-
prescriptions.
P-405
Psychotropic drug prescription is associated with falling in
nursing home residents
H. van Jaarsveld
1
, C.A. Cox
2
, S. Houterman
3
, J.C.G.H. van der
Stegen
4
, A.T.M. Wasylewicz
3
, R.J.E. Grouls
3
, C.M.J. van der Linden
3
1
Catharina Hospital Eindhoven, Rotterdam, Netherlands;
2
Maastricht
University, Eindhoven, Netherlands;
3
Catharina Hospital Eindhoven,
Eindhoven, Netherlands;
4
Vitalis Behandelgroep, Eindhoven,
Netherlands
Objective:
The objective of this study was to assess the association
between fall incidence and the prescription of psychotropic drugs
on a day to day basis in nursing home residents. Falling is a
common problem among elderly. Previous studies suggest that
the use of psychotropic drugs increase the risk of falling. However,
the contribution of these drugs on fall risk among nursing home
residents has not been quantified on a daily basis until now.
Methods:
In this retrospective study, we collected data about fall
incidence and the prescription of antipsychotics, antidepressants
and benzodiazepines for each day over a 2-year period. Residents
were included if they lived in one of the nine nursing homes of the
Vitalis WoonZorg Groep in Eindhoven, the Netherlands. Generalized
Estimating Equations was used to analyze the association between
psychotropic drug prescription and falling.
Results:
A total of 2,368 nursing home residents were included,
which resulted in a dataset of 538,575 person-days. The prescription
of psychotropic drugs resulted in almost a threefold increase in fall
risk (OR 2.99; 95% CI 1.58–5.63). The prescription of antipsychotics
(OR 2.00; 95% CI 1.60–2.51), benzodiazepines (OR 1.47; 95% CI 1.18–
1.84) and antidepressants (OR 2.78; 95% CI 1.72–4.48) was also
associated with an increased fall risk.
Conclusions:
The prescription of psychotropic drugs is associated
with a strongly increased risk of falling among nursing home
residents. For this population, psychotropic drugs should be
prescribed with great caution.
Financial disclosure:
None.
P-406
Ofloxacin-induced fulminant hepatitis: a case report
C. Joyau
1
, G. Veyrac
1
, A. Deininger
2
, L. Triquet
3
, F. Delamarre
Damier
4
, P. Jolliet
5
1
Clinical Pharmacology Department
–
Biology Institute, Nantes,
France;
2
Pharmacy Department
–
Saint Nazaire Hospital, Saint-
Nazaire, France;
3
Department of Pharmacovigilance Center, Rennes,
France;
4
Cholet Hospital, Cholet, France;
5
Clinical Pharmacology
Department, Nantes, France
Introduction:
Fluoroquinolones (FLQ) are widely used for
treatment of bacterial infections in elderly patients. FLQ are known