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Sick Day Management: Medications to Hold | Drug News | July2020

July 2020 | Drug Information and News for Health Care Providers | View PDF

The COVID-19 pandemic has created unique challenges for older adults. It has been shown that acute infectious diseases can cause dehydration and volume depletion, which subsequently increases the risk of acute kidney injury and adverse effects of certain medications, leading to a high mortality rate in this population.1,2 It is for this reason that several medications should be stopped temporarily for residents who have symptoms such as a fever, diarrhea, or vomiting, or cannot eat or drink. These medications, which can be remembered by using the acronym “SADMANS,” are listed in the table below.

Note: Combination products that contain any of the types of medications listed in this table should also be temporarily stopped during illness. References for table: 3, 4

1. Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney International 2020;97:829-838.
2. Parmar MS. Sick days off – a simple strategy to prevent acute kidney injury and other adverse drug reactions. The Pharmaceutical Journal. October 16, 2017.
3. Canadian Diabetes Association. Appendix 8: Sick Day Medication List. Can J Diabetes 2018;42:S316.
4. Rx Files. Type 2 diabetes and sick days. Medications to pause. 2018.

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