Journal of Aging Science

Abstract

Morbus Diureticus in the Elderly (MDE)-Inappropriate Application of Diuretics Four Case Reports

Alexandra M Kuhn-Thiel, Heinrich Burkhardt and Martin Wehling

Background: Diuretics still enjoy continued popularity for elderly patients, both in terms of effectiveness in reliably lowering blood pressure and cost considerations. Due to the frequency not only of the indications prompting prescription of diuretics, but also the high rate of drug prescription itself in this context, attempts have been made to quantify their overall toxicity and their contribution to adverse drug events and cases of hospitalization in elderly patients, particularly those with multiple illnesses and polypharmacy. Adverse drug reactions (ADRs) commonly observed and recorded which may specifically be attributed to diuretics during visits to the emergency ward and during hospital stays include: dehydration, dizziness, falls, electrolyte disturbances potentially culminating in delirium, and thrombosis. Case presentation: Four cases of diuretic toxicity in the elderly are reported in this paper, representing variable features of a complex, but typical syndrome for which the term Morbus diureticus in the elderly has been proposed. The clinical picture, treatment and outcome of four patients displaying varying symptoms and degrees of severity as described above have been recorded and assessed according to our definition of Morbus diureticus. Conclusion: These cases are by no means extraordinary or uncommon. They have been selected to illustrate the array of challenges associated with the prescribing and monitoring of diuretic use. The compromising use of diuretics could be amended in all the cases described here, resulting in the patients’ satisfactory to excellent recovery.