Iatrogénie médicamenteuse chez la personne âgée: à propos de deux cas d’insuffisance rénale favorisée par les tricycliques

Abstract

Prostatic hyperplasia is a common condition in people over the age of 50 and its incidence increases with age. It gives particular cause for concern when it is symptomatic. Drugs with potential adverse effects on lower urinary tract can induce symptoms. Among those, anticholinergic drugs causing primary or secondary effects, such as tricyclics, are often associated with symptoms. These are contraindicated in patients with subvesical obstruction because they can induce or worsen urinary symptoms and complications resulting from them. Renal failure having health and economic consequences on elderly subjects Who often suffer from multiple disorders is the most severe complication. We report two cases of tricyclics-related adverse effects on the urinary tract in patients with prostatic hyperplasia ranging between 80 and 92 years. Given the lack of semiologic signs, imaging techniques and bladder TC scan enabled etiological diagnosis allowing adequate management. Study results justify a systematic performace of rectal examination, bladder CT scan or even ultrasound in any elderly with acute renal failure or with a worsening of chronic renal failure based on the frequency of prostatic pathologies and polypharmacy in this age.

Keywords: Iatrogenia, elderly, tricyclics, benign prostatic hyperplasia, renal failure