38 CHAPTER 2.1 Table 1. The original ADR trigger tool as published in the Dutch national geriatric guideline ‘polypharmacy optimisation in hospitalised older people’ and the explicated ADR trigger tool used for this research. Original ADR trigger tool Explicated ADR trigger tool Trigger Associated drug Trigger Associated drug 1.Fracture / falla A. Steroids B. Psychotropic agentsa C. Antihypertensive agentsa 1. Fracture A. Systemic corticosteroids 2. Collapse / hypotension / dizziness A. Cardiac therapy (antihypertensive and antiarrhythmic agents) B. Psychotropic agents 2. Falla / collapse / (orthostatic) hypotension / dizziness / syncope A. Antihypertensive agentsa: ACE-I, ARB, calcium antagonists, beta blockers, thiazide diuretics, loop diuretics, potassium sparing diuretics, alpha-1-blockers, long acting nitrates. Antiarrhythmic agents: digoxin, class I, II and III antiarrhythmics B. Psychotropic drugsa: benzodiazepines, antipsychotics, antidepressants (i.e. SSRI, TCA and miscellaneous: duloxetine, venlafaxine and mirtazapine) 3. Bleeding (mostly gastrointestinal) / INR above therapeutic range A. Anticoagulants B. Thrombocyte aggregation inhibitors C. NSAIDs 3.1 Gastrointestinal bleeding3.2 Intracranial bleeding 3.3 Other bleedings A. Vitamin K antagonists, DOACs, heparins, other anticoagulants B. Thrombocyte aggregation inhibitors C. NSAIDs 3.4 Supratherapeutic INR A. Vitamin K antagonists 4. Electrolyte disturbances / dehydrationb A. Diuretics B. ACE-I, ARB C. NSAIDsb D. Antidepressants 4.1 Hyponatraemia A. Thiazide diuretics, loop diuretics, potassium sparing diuretics B. ACE-I, ARB C. Antidepressants (i.e. SSRI, TCA and miscellaneous: duloxetine, venlafaxine and mirtazapine) 4.2. Hypokalaemia A. Thiazide diuretics, loop diuretics 4.3. Hyperkalaemia A. Potassium sparing diuretics B. ACE-I, ARB
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