Background Hydroxyzine is an antihistamine used in the symptomatic treatment of anxiety, itching and urticaria, and as an anaesthetic premedication. However, there is a risk of the prolongation of the QT interval and ventricular arrhythmia (torsade de pointes). This effect is known and is described in the technical sheet. In 2015, after the evaluation by the Pharmacovigilance Risk Assessment Committee, the Spanish Agency for Medicines and Medical Devices (AEMPS) published an informative note on restrictions in order to minimise their arrhythmogenic risk. After evaluating available data, the AEMPS recommended, among other things, not to use in elderly patients, given the lower elimination rate and higher risk of adverse reactions, mainly due to anticholinergic effects. The Beers criteria also label this medication as potentially inappropriate medication in elderly patients.
Purpose To study the frequency of these inappropriate prescriptions in order to establish strategies for their prevention.
Material and methods Retrospective study of all admitted adult patients who received hydroxyzine treatment during the 2 years immediately following the alert (13 February 2015–12 February 2017). For this purpose, prescription histories in the electronic prescribing program (Farmatools) were reviewed and data were analysed, taking into account the age of each patient. Analysis of data was done through descriptive statistics.
Results A total of 176 hydroxyzine prescriptions were found (79 males, 97 females). Mean age of the patients who received treatment was 66.32 years, with an age range of 20 to 96 years. The percentage of patients older than 65 years (% of patients with inappropriate prescriptions) was 63.58%. The average duration of treatment was 5.82 days (1–38 days).
Conclusion A high percentage of hydroxyzine prescriptions were inappropriate, although most of them were of short duration (78% less than 10 days). Given the results provided, it is evident of the need to include a review of the consumption of drugs, to contribute to an adequate use of them, as well as the awareness of professionals towards this group and the possible taking of other measures. Certain medications have a greater potential to cause problems when used by the elderly. Several studies have shown that inappropriate prescription in elderly people is highly prevalent but preventable.
References and/or acknowledgements None.
No conflict of interest.
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