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Syncope and presyncope associated with probable adverse drug reactions
J T Hanlon1, M Linzer, J P MacMillan
1Division of Geriatric Medicine, Duke University Medical Center, Durham, NC 27710.
Archives of Internal Medicine
|November 1, 1990
Summary
Adverse drug reactions frequently cause syncope and presyncope, particularly in older adults on multiple medications. This study identified probable drug-induced events in 13% of patients, highlighting medication risks.
Area of Science:
- Pharmacology
- Geriatrics
- Clinical Medicine
Background:
- Syncope and presyncope are common clinical presentations.
- Drug therapy is a potential contributing factor to these events.
- Identifying drug-induced causes is crucial for patient management.
Purpose of the Study:
- To investigate the association between drug therapy and syncope/presyncope.
- To quantify the incidence of probable drug-induced syncope and presyncope.
- To identify patient characteristics associated with drug-induced events.
Main Methods:
- Prospective study of 70 patients referred to a tertiary care ambulatory clinic.
- Drug use information was obtained, validated, and classified by syncope/presyncope potential.
- A standardized adverse drug reaction algorithm was utilized.
Main Results:
- Nine patients (13%) experienced probable drug-induced syncope and presyncope.
- Twelve different medications were implicated in these adverse events.
- Patients with drug-induced events were older, took more medications, or used antihypertensives.
Conclusions:
- Syncope and presyncope are frequently linked to adverse drug reactions.
- Elderly patients and those on polypharmacy are at higher risk.
- Medication review is essential for patients presenting with syncope of unknown origin.