ABSTRACT
I. CLINICAL RELEVANCE A. Adverse Drug Reactions and Events The purpose of this chapter will be to examine the pharmacological approach to the critically ill geriatric patient. Particular consideration will be given to the recognition and prevention of adverse drug reactions (ADRs) and adverse drug events (ADEs) in critically ill geriatric patients. Although these two terms may appear synonymous and are often used interchangeably in the literature, an ADE is generally considered a broader definition, which can include injuries caused by errors in administration or noncompliance. An ADR, on the other hand, is regarded as ‘‘any response to a drug which is noxious and unintended and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease for the modification of physiological function’’ (1). For reporting purposes, the U.S. Food and Drug Administration categorizes a serious adverse reaction (events relating to drugs or devices) as one in which ‘‘the patient outcome is death, life threatening (real risk of dying), hospitalization (initial or prolonged), disability (significant, persistent, or permanent), congenital anomaly, or required intervention to prevent permanent impairment or damage.’’
