Drug Induced Falls

This is an important topic excerpted from our O’Donnell’s Drug Injury IVth Ed. book

Significant contribution to Falls

Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.

In theory, ANY drug that causes one of the following effects can increase the risk of falling:

  • Drowsiness
  • Dizziness
  • Hypotension
  • Parkinsonian effects
  • Ataxia/gait disturbance
  • Vision disturbance

Greatest risk:

  • Sedative / hypnotics
  • benzodiazepines, especially long half life (Valium)
  • Blood pressure medicines  –  too much, get up too fast, dizzy and fall.
  • Alcohol plus any drug increasing fall risk – overall significantly greater fall risk.

Falls account for over 8 million hospital emergency room visits, representing the leading cause of visits (21.3%). Slips and falls account for over 1 million visits, or 12% of total falls. The CDC also reports that approximately 1.8 million people over the age of 65 were treated in an emergency room as a result of a fall. For people aged 65-84 years, falls are the second leading cause of injury-related death; for those aged 85 years or older, falls are the leading cause of injury-related death. Incidence of falls goes up with each decade of life.

Fractures are the most serious consequences of falls and occur in 5% of all people who fall.

Slips and falls are the leading cause of workers’ compensation claims and are the leading cause of occupational injury for people aged 55 years and older.

Half of all accidental deaths in the home are caused by a fall. Most fall injuries in the home happen at ground level, not from an elevation. Of all fractures from falls, hip fractures are the most serious and lead to the greatest health problems and number of deaths. The following statistics describe the slip-and-fall crisis affecting our nation’s elderly. Each year in the United States, one of every three persons over the age of 65 will experience a fall. Half of which are repeat fallers. According to the CDC In 2005, more than 15,000 people over the age of 65 died as a result of a fall. Up from 7,700 a decade earlier.

See Barbara Cadario and BC Falls and Injury Prevention Coalition. Drugs and the Risk of Falling: Guidance Document. Revised August 2011.  

Opiate Toxicity Video

Not a day goes by without multiple news reports about the opiate epidemic and opiate deaths in all walks of life. Dr. James J. O’Donnell has prepared a video explaining how opiates cause toxicity, specifically suppression of breathing, which is the mechanism of death in opiate toxicity and overdose.

This scenario presents in criminal law (drug induced homicide), as well as in civil/health care malpractice. Deaths occur on the street, in the hospital, and after discharge at home.

Drug Allergy Video

Allergic reactions can occur with any drug. Patients need to be constantly asked about allergic reactions, and notes/warnings/flags about allergies must be posted on all medical, health, pharmacy, and dental records. Some drugs cause allergies more than others, and patients with multiple allergies are at risk for more allergies and more severe reactions. Allergic reactions can be minor, a rash, itching, or severe/deadly, an anaphylaxis – unable to breath, loss of pulse, or severe swelling/ rash on the skin.

The minor reactions, with no prior reaction hisory, are unavoidable. They are important, and must be noted, because the second or subsequent exposures can result in a severe or deadly reaction. As a result of this, severe reactions are, in most cases, avoidable.

The video, presented by James T. O’Donnell Pharm D, discusses allergic reactions, risks, avoidance, and provides guidances for risk reduction of this very common and frequently deadly adverse drug reaction.

Pharmacist Errors

A recent front page story in the Chicago Tribune reporting more than 50% of pharmacists tested failed to detect and warn about dangerous drug interactions made national news, and calls by the Illinois Governor for increased enforcement of the Illinois Pharmacy Practice Act.

The video below on pharmacists errors is presented by James Thomas O’Donnell, a pharmacist who has served as a pharmacy college professor, the Founding Editor of the Journal of Pharmacy Practice, and a frequent consultant and expert witness in pharmacist error cases.

The type, frequencies and severity of errors are reviewed, and recommendations made to help individual patients avoid injury by pharmacist errors.

Ambien Sleep Driving

Ambien is a benzodiazepine-like drug (ie, Xanax) which is used as a sleeping pill. It induces a rapid descent into sleep. One of its classic side effects is anterograde amnesia. After taking the pill, the person may be awake and functional for some time before falling asleep, but they may have no recollection of that time afterwards. More importantly, after falling asleep, people get up, sleep walk, sleep cook, sleep drive, and even sleep-sex. People may Continue reading