European Geriatric Medicine - Supplement 1 - Volume 6

Poster presentations / European Geriatric Medicine 6S1 (2015) S32

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S156

S141

to cause liver enzymes increase as a class effect. Severe liver injury,

like fulminant hepatitis, remains rare but sometimes fatal.

Objectives:

To report a fatal case of a patient treated with ofloxacin

who developed fulminant hepatitis.

Observation:

This case concerns a 84 year-old female patient, with

history of chronic alcoholism. She has been treated with ofloxacin

(400mg per day) for cystitis. Three days after the beginning of

treatment, she developed fulminant hepatitis (ALAT: 1484 UI/L,

ASAT: 5206 UI/L). Meanwhile, she had hypoglycemia, hypotension

and bradycardia. The patient died three days after the beginning of

the symptoms. Liver function tests performed 15 days before were

normal.

Conclusion:

The hepatotoxic mechanism of fluoroquinolones is

not completely understood. Trovafloxacin marketed in 1997 was

withdrawn from the European market two years later because of

its hepatotoxicity secondary to a toxic metabolite. The formation of

this metabolite is linked to some functional groups of the structure

of trovafloxacin, which are not found in other fluoroquinolones.

The rapid onset, recurrence of a more serious attack if rechallenge

and the lack of common metabolites argue for an immuno-allergic

mechanism. Given the scarcity of the effect, it is difficult to compare

the incidence among different fluoroquinolones. Both physicians

and patients need to be aware of potential symptoms and take

prompt action if signs of hepatotoxicity emerge, especially in elderly

fragile patients.

P-407

Drug-induced taste disorders: prescribing analysis in French

nursing homes

C. Joyau

, G. Veyrac

, F. Delamarre Damier

, A. Pasquier

, J. Priez

P. Jolliet

Clinical Pharmacology Department

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Biology Institute, Nantes,

France;

Cholet Hospital, Cholet, France;

Clinical Pharmacology

Department, Nantes, France

Introduction:

Taste disorders may lead to drug noncompliance,

nutritional deficiencies, diseases increase and depression. They

are suspected adverse reactions in 11% of cases of elderly

polymedicated population. Many diseases are also involved in these

disorders.

Objective:

To overview drugs associated with taste disorders based

on nursing home prescriptions

Methods:

104 resident’s prescriptions were analysed. A descriptive

analysis of the population was carried out. A research was

performed for each drug in reference books, literature and

European database of suspected adverse drug reaction reports

(Eudravigilance) to determine whether the drugs could be

responsible for taste disorder.

Results:

Among the 104 prescriptions, there were 78 women (75%)

and 26 men (25%) with a median age of 87 years (range 45–106).

The median number of drugs lines was 8.5 (range 1–20). 905 drug

lines were notified with 234 different drugs; taste disorders were

described for 66 of them in reference books (mostly drugs acting

on the renin-angiotensin system and antidepressants).

Conclusion:

According to bibliography, taste disorder as a iatrogenic

effect can be explained by different mechanisms: xerostomia,

especially with anticholinergic drugs, zinc deficiency, copper or

vitamin A as well as altered sense of taste. Lots of drugs may

be responsible of taste disorders and this problem greatly affect

residents quality of life and health. Physicians should be aware of

drug related taste disorder and may try to find alternative therapy.

P-408

Accumulation of potentially harmful drugs and its association

with mortality among older people in assisted living facilities

in Helsinki and in nursing homes in Kouvola, Finland

A.-L. Juola

, S. Pylkkanen

, M. Bjorkman

, H. Finne-Soveri

H. Soini

, H. Kautiainen

, J.S. Bell

, K. Pitk¨al¨a

City of Porvoo, Helsinki, Finland;

Carea, Kotka, Finland;

University

of Helsinki, University of Helsinki, Finland;

National Institute for

Health and Welfare, Helsinki, Finland;

City of Helsinki, Helsinki,

Finland;

University of South-Australia, Adelaide, Australia

Objective:

Because little is known how the use of potentially

harmful drugs according to various criteria overlaps and

accumulates among older residents in institutional settings and

how this accumulation affects their prognosis, we wanted to

investigate the use, accumulation and overlapping of various PHDs

(categories: anticholinergic properties (DAPs),

2 psychotropics

and Beers’ drugs) among older people in institutional settings in

Finland. We compared the characteristics and mortality of residents

using PHDs from one, two or three categories with those using

none.

Methods:

The data of residents (N = 326) was collected in assisted

living facilities in Helsinki and in nursing homes in Kouvola, Finland.

Three different criteria for PHDs were used (DAPS, Beers’ drugs and

use of

2 psychotropic drugs at one time). Participants’ quality-

of-life was assessed by 15D measure and psychological well-being

scale (PWB). Mortality during three follow-up years was retrieved

from central registers.

Results:

Of participants, 12.6%, 28.2%, 38.0% and 21.1% used PHDs

according to three, two, one or none criteria, respectively. Those

using PHDs according to three criteria had highest number of

medications, lowest PWB and a trend towards lower 15D. Largest

proportion of those using no PHDs had best self-rated health.

There was no difference in comorbidities, cognition or functioning

between the groups. There was no association between use of PHDs

and three-year mortality.

Conclusion:

The use of PHDs in institutional settings is common

when defined by various PHD criteria. Their use is associated with

lower QOL.

P-409

Mortality in very old patients using statins with high

cholesterol and albumin serum levels

D. Justo

, M. Tchernichovsky

, H. Mayan

Sheba Medical Center, Ramat Gan, Israel;

Rappaport School of

Medicine, Haifa, Israel

Objectives:

To evaluate the association between statin therapy and

mortality in elderly patients aged 80 years or more.

Methods:

A historical prospective study in a single Internal

Medicine department during one year. Included were all elderly

patients aged 80 years or more using statins upon hospital

admission and hospital discharge (n = 317; study group), and all

elderly patients aged 80 years or more neither using statins upon

hospital admission nor upon hospital discharge (n = 386; control

group). The all-cause 3-year mortality rate was studied in both

groups as well as its association with statin therapy.

Results:

The final cohort included 703 elderly patients: 413 (58.7%)

were women; the mean age was 86

5 years. Overall, 350 (49.8%)

patients died within three years of hospital discharge. The all-

cause 3-year mortality rate was lower in the study group than in

the control group (143 vs. 174 patients; 40.9% vs. 49.3%; relative

risk 0.84; 95% confidence interval 0.73–0.97; p = 0.028), but a

logistic regression analysis showed that statin therapy was not

independently associated with mortality. In a subgroup analysis of

88 (12.5%) patients aged 86 years or more with both high total-

cholesterol and albumin serum levels, the cumulative survival rate