Klin Farmakol Farm. 2026;40(2):77-86 | DOI: 10.36290/far.2026.003

Potentially inappropriate drugs in patients with chronic ischemic heart disease

Mária Kolesárová¹, Martina Dobrovičová², Dalibor Kolesár³

¹ Katedra farmakológie a toxikológie, Univerzita veterinárskeho lekárstva a farmácie v Košiciach

² Ústav farmakológie, Lekárska fakulta, Univerzita Pavla Jozefa Šafárika v Košiciach

³ Ústav anatómie, Lekárska fakulta, Univerzita Pavla Jozefa Šafárika v Košiciach

As a result of population aging, the rate of polymorbidity and the associated polypharmacy and polypragmasia are increasing. There is an increased risk of drug interactions, adverse effects, and the likelihood of inappropriate drug use in the elderly population. The aim of this retrospective study was to analyze the medication history of older adult patients with chronic ischemic heart disease (IHD) and to identify potentially inappropriate medications (PIMs). Data were collected over a one-month period from the prescription records of patients who were institutionalized in a social services home. PIMs were identified according to the current Beers criteria (2023). The patient cohort (n = 70) consisted of 73 % women and 27 % men, with a mean age of 84 years ± 6.73 years. A total of 51 comorbidities were identified in the patients. Most patients had cardiovascular (89 %) and psychiatric and neurological (61 %) comorbidities. The most commonly prescribed medications in the treatment of the primary diagnosis of IHD were beta-blockers (28 %). The prescription of at least one PIM was recorded in 70 % of patients. According to the 2023 Beers criteria, which recommend avoiding PIMs, promethazine (3 %), digoxin (6 %), quetiapine (4 %), benzodiazepines (30 %), zolpidem (9 %), and proton pump inhibitors (42 %) were identified in more than one patient. In 20 % of patients, PIMs related to drug-disease interactions were identified because benzodiazepines or certain antipsychotics had been prescribed despite a diagnosis of dementia or dementia-related delirium. The medications that need to be used with caution in older adults were evaluated as dabigatran (3 %), antidepressants (22 %), antipsychotics (21 %), diuretics (28 %), tramadol (14 %), and sodium-glucose cotransporter inhibitors (8 %).

Keywords: elderly, ischemic heart disease, polymorbidity, polypharmacy, polypragmasia, potentially inappropriate drugs.

Received: September 5, 2025; Revised: January 9, 2026; Accepted: January 19, 2026; Published: July 1, 2026  Show citation