Case reportDifculty in managing polypharmacy in the elderly: Case report andreview of the literatureRhita Bennis Nechba a, b, *, Moncif El M'barki Kadiri c, Mounia Bennani-Ziatni d,Amine Ali Zeggwagh e, Abdelhalim Mesoui baDepartment of Medicine, El Idrissi's Hospital, Kenitra, MoroccobLaboratory of Genetics, Neuroendocrinology and Biotechnology, Ibn Tofal University, Kenitra, MoroccocDepartment of Nephrology, Dialysis and Transplantation, Military Hospital, Rabat, MoroccodDepartment of Chemistry, Ibn Tofal University, Kenitra, MoroccoeDepartment of Intensive Care, Avicenne University Hospital, Rabat, Moroccoarti cle i nfoArticle history:Received 13 December 2013Received in revised form28 May 2014Accepted 5 June 2014Available online 26 August 2014Keywords:drugedrug interactionselderlyiatrogenypolypharmacyskin lesionabstractElderly patients with multiple comorbidities are at risk of experiencing adverse drug events. We report acase of skin lesion related to drugs and discuss consequences of polypharmacy in the elderly. An 85-year-old female took the following drugs for a long time: amlodipine, valsartan, hydrochlorothiazide, lysineacetylsalicylate, sinvastatine, and trimetazidine. In June 2013, she presented thoracic pain and receivedpropranolol, tramadol, andparacetamol. Oneweeklater, shedevelopedadiffuseskinlesion. Inourpatient, drugsconsideredunnecessarywerediscontinuedandcorticosteroidwasadministeredorally.Careful monitoring helped improve the outcome. Corticoids were dangerous but necessary to correct theconsequence of iatrogeny.Copyright 2014, Asia Pacic League of Clinical Gerontology & Geriatrics. Published by Elsevier TaiwanLLC. All rights reserved.1. IntroductionThe frequency of chronic illness and the expenditure for medi-cationsincreasewitholderage.1Polypharmacyandprescriptionpracticesresultinincreasedimpairmentinqualityoflifeandindrug-related morbidity and mortality.2Nearly 50% of older adultstakeoneormore medications thatare not medically necessary.3Polypharmacyisvariouslydenedasalargenumber ofmedica-tions (> 5e10), use of more drugs than clinically indicated, or use ofinappropriatemedications.4Aliteraturereviewfoundthatpoly-pharmacycontinuestoincrease.5,6Basedonpolypharmacyandage-related pharmacokinetic and pharmacodynamic changes,therisks of adverse drug reaction and adverse drug event areincreasing in elderly patients.7e10In fact, it is estimated that elderlypeople have four times greater odds of beinghospitalizedforadversedrugreactionsthanthose