The Top 4 Drugs That Can Land You in the Emergency Room

We could save significantly on health care use by cutting back on the adverse drug events caused by blood thinners and diabetes meds.


A few medications cause most of the problems that lead to emergency hospitalization in older patients, according to a recent article in the New England Journal of Medicine.

Adverse drug events (ADEs) leading to emergency department (ED) visits or emergency hospitalizations are particularly common in older patients. By identifying these high risk drugs, hospitalizations can be prevented.

Investigators used 2007-2009 data from a nationally representative sample of 58 hospitals to examine 100,000 hospitalizations due to major drug side effects.

Almost half (48 percent) of ADE-related hospitalizations among elders occurred in patients older than 80. Four medications accounted for more than two-thirds of these ADE-related emergency hospitalizations: warfarin (a blood thinner to prevent clots), insulins (for diabetes), oral antiplatelet agents (for heart attack prevention), and oral hypoglycemic agents (for diabetes).

The nearly 100,000 annual emergency hospitalizations caused by ADEs in older patients represent an opportunity to prevent patient harm and lower health care use and costs. How can we help our loved ones with their medications?

Make sure an up-to-date card is kept by each person that documents the entire medication list, including vitamins, herbs, and OTC medicines. The list should be kept in their wallet. Some patients see multiple doctors. A handy, up-to-date medication list shown to a physician can save a life. Most critical errors in medicine are related to either the physician or the patient not having a current medication list. As a result, more drug adverse side effects and interactions occur.

Alert your loved ones that blood thinners and diabetic medicines account for 50 percent of hospitalizations due to ADEs. Blood thinners and diabetes medications can regularly be monitored by the primary care physician. Such monitoring should be encouraged to prevent emergency room visits and subsequent hospitalizations due to excessive bleeding or very low blood sugars.

Encouraging medication compliance can lengthen a person's lifespan. Too many times patients stop their medications due to a comment made by a friend or a study that was read on the Internet. Often the doctor is not informed and the patient may not understand the positive effects of the medication. Communication with the physician is essential.

Keeping a medication list, making sure that each medicine is taken, and monitoring high-risk medications should be easy, yet tens of thousands die each year in the U.S. as a result of such mistakes.

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Evan Lipkis is a physician, professor, and author. He practices internal medicine at Glenbrook Hospital and served as the medical consultant for WGN radio. He is also an editorial advisor for Prescriber's Letter, a newsletter for physicians.

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