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Polymedication is a well-known issue in the elderly

since it is linked with potentially inappropriate medication (PIM). One

of the objectives of the IPOP study was to evaluate the prescriptions in

the community setting in France in order to have a descriptive view of

the potential PIM in a large cohort of elderly patients.


Elderly patients (>65 years) with 3 or more medications

visiting one of the 81 participating community pharmacies were

included. Prescriptions were analyzed with the Beers criteria (JAGS-

2015) for the detection of PIM in elderly patients according to their 5

main lists of criteria.


905 patients (1 prescription/patient) were included (women:

54.4%; median age: 77). 6839 drugs were prescribed (mean/median:

7.6/7 drugs). 751 (83.0%) patients had at least one Beers criteria for PIM

use. 664 (73.4%) patients had at least one Beer criteria for PIM due to


disease/syndrome. 489 (54.0%) patients had at least one Beers

criteria for PMI to be used with caution. 139 (15.4%) patients had at

least one Beers criteria for potentially clinically important non-anti-

infective drug

drug interactions. 167 (18.5%) patients had at least one

Beer criteria for non-anti-infective medications that should be avoided

or have their dosage reduced with renal function. Multivariate analysis

reported that when the number of drugs/prescription increased then

the risk of PIM increased.


IPOP reported that many patients are potentially exposed

to PMI because of their age. It is therefore important to use tools/

criteria in order to improve the safety of the treatment.


Comprehensive geriatric care reduces potentially inappropriate

prescribing in frail, anemic elderly patients with a hip fracture

M.E.J. Jensen


, M. Gregersen


, E.M. Damsgaard




Department of

Geriatrics, AUH Aarhus University Hospital, Aarhus, Denmark


Frail elderly patients are vulnerable to potentially

inappropriate prescriptions (PIPs) and accordingly comprehensive

geriatric care (CGC) includes a review of the patient

s medication. The

Screening Tool of Older Peoples Prescriptions (STOPP) has been

developed to identify PIPs among elderly patients. The present study

aims to investigate if CGC reduces the number of PIPs among frail,

anemic, elderly patients with hip fracture.


Using data from the

Transfusion Requirements In Frail


(TRIFE) study, we investigated medication among 50 conse-

cutive frail patients aged 65 or more, admitted to Aarhus University

Hospital from a nursing home or sheltered housing with a unilateral

hip fracture between October 10, 2012 and June 6, 2013. All the

patients received CGC. Using the STOPP criteria, we identified the

prevalence of PIPs at admittance and after the termination of CGC

(30 days).


The mean age of the patients was 87 years (SD 7.4), 80% were

women, and 70% came fromnursing homes. The prevalence of patients

with at least one PIP, as defined by the STOPP criteria, was 86% at

admission and 79% at termination of the CGC. The median number of

PIPs at admittance was 2 (IQR 1

3) compared to 1 (IQR 1

3) at

termination (P = 0.0045).


CGC significantly reduced the prevalence of PIPs in this

group of patients, but did not remove them entirely. This may indicate

that some patients

PIPs represent necessary medication. It certainly

emphasises the need for continued focus on the quality of prescribing

among frail, elderly people.


Hypoglycemic coma with fatal outcome in a patient treated with

cotrimoxazole and sulphonylurea

C. Joyau


, G. Veyrac


, L. Nicolet


, F. Delamarre-Damier


, P. Jolliet




Pharmacology Department, Biology Insitute, University Hospital,


Intensive Care Unit, University Hospital, Nantes,


Monfort Nursing

Home, Saint Laurent sur Sèvre,


AGREE French Nursing Home Research

Organization Chateau Thébaud,


EA4275 Biostatistics,

Pharmacoepidemiology and Subjective Health Measure, Medicine

University, Nantes, France


Hypoglycemia can lead to severe complications such

as coma. Some drugs like sulfonylureas can cause this disorder.

Hypoglycemia is also a known side effect of cotrimoxazole.


To report a fatal case of hypoglycemic coma in a patient

treated with glimepiride and cotrimoxazole.


This case concerns a 62 year-old male patient treated

with glimepiride for diabetes. In August 2015, cotrimoxazole treat-

ment was started in a context of Staphylococcus aureus infection and

the patient developed renal failure. A few days later, the patient fell

into a coma with Glasgow score 3 and capillary blood sugar level of

0,13 g/L. Hypoglycemic coma was retained. The patient died 7 days

after the beginning of the first symptoms.


Fixation of glimepiride on potassium channel ATP-

sensitive in the beta cells of Langerhans islets causes inhibition of

potassium efflux, resulting in cellular cell depolarization causing

insulin release. Sulfamethoxazole is a sulfonamide chemically similar

to sulphonylureas. Glimepiride is metabolized by cytochrome 2C9;

sulfamethoxazole is a potent inhibitor of this cytochrome. These data

suggest pharmacodynamic and pharmacokinetic interaction. In the

summary of products characteristics (SPC) of glimepiride, potentiation

of hypoglycemic effect is mentioned with certain drugs including

some long acting sulfonamides. In cotrimoxazole SPC, safety precau-

tion is noted with chlorpropamide, tolbutamide (two sulfonylureas).

Several publications suggest an increased risk of hypoglycemia when

cotrimoxazole is associated with glyburide or glipizide. We didn

t find

any publication mentioning an interaction between cotrimoxazole

and glimepiride. Health professionals should remain vigilant for

hypoglycemia in patients receiving these drugs, especially in patients

with renal failure.


Use of QT- interval prolonging drugs in patients admitted to

geriatric department

S. Krajcik


, P. Mikus


, Z. Janoskova




Slovak Medical University,


University Hospital Bratislava

Usage of QT interval prolonging drugs was assessed in 231 patients (65

men and 166 women) being admitted to geriatric department with

average age 82 yrs (range 66

99 yrs). 80.3% of patients came from

home, the rest were transferred from other departments. 80 (34.6%)

patients used no drug prolonging QTc 72(31.2%) 1 drug, 50 (21.6%) 2

drugs, 23(10%) 3 drugs and 5(2.1%) 4

6 drugs. Use of QT prolonging

drugs was increasing with age (60% in age group 65

74 years, 67.9% in

age group 75

84 years and 78% in patients over 84 years) Patients

transferred from other departments used these drugs more often than

those coming from home (75.6%, resp. 69.9%). The most frequently

used groups were diuretics (36%), antipsychotics (24%), pantoprazol

(22.5%) and antidepressive drugs (10.4%). Patients using QTc prolong-

ing drugs died more often in next 3 months (30.3% versus 16.7%). The

difference was biggest in those using more than 1 drug (43.7% in

deceased and 28.7% in surviving patients).


STOPP Frail (Screening Tool of Older Persons Prescriptions in Frail

Adults with Limited Life Expectancy): consensus validation

A.H. Lavan


, P. Gallagher


, C. Parsons


, D. O






University Hospital,


University College Cork,


Queens University Belfast


To validate STOPPFrail, a list of explicit criteria for

potentially inappropriate medications (PIMs) in frailer older adults

with limited life expectancy. A Delphi consensus survey of an expert

panel (n = 17) comprising specialists in geriatric medicine, clinical

pharmacology, palliative care, psychiatry of old age, clinical pharmacy

and general practice.


STOPPFrail criteriawas initially created by the authors based

on clinical experience and appraisal of the available literature. Criteria

were organised according to physiological system. Panellists ranked

their agreement with each criterion on a 5-point Likert scale and

invited to provide written feedback. Criteria with a median Likert

Poster presentations / European Geriatric Medicine 7S1 (2016) S29