Medications and the elderly

• Many medical conditions seen in the elderly, such as dementia, Parkinson disease, and cardiovascular problems can be worsened by a tricyclic antidepressant. If a tricyclic is chosen as a second-line medication, then nortriptyline and desipramine are the best choices given that they are less anticholinergic.[16]

Medication-related admissions in older people can be caused by adverse drug reactions, failure to take a prescribed medication and errors with taking medications. Medicines can be problematic for older people because as we age physiological changes can affect the way our body absorbs, distributes, metabolises and eliminates drugs.

How does medication affect the elderly?

These physiological changes include increased body fat, decreased body water, decreased muscle mass, and changes in renal and liver function and in the Central Nervous System. These changes can cause adverse drug reactions (ADRs) in older people .

What is the most common medication problem in the elderly?

Warfarin is one of the most common causes of medication -related hospitalizations in older adults . To reduce the risk of serious problems , one may need to apply extra care in monitoring warfarin effect (via the prothrombin blood test) and extra care in checking for interactions when a new drug is prescribed.

Why are elderly more sensitive to drugs?

4. Increased Sensitivity to Many Drugs : The problems of decreased body size, altered body composition ( more fat, less water), and decreased liver and kidney function cause many drugs to accumulate in older people’s bodies at dangerously higher levels and for longer times than in younger people.

What drugs should be avoided in geriatric patients?

Drugs to Be Used With Caution in Older Adults (Based on the American Geriatrics Society 2015 Beers Criteria Update) Carbamazepine . Carboplatin . Cyclophosphamide. Cisplatin. Mirtazapine. Oxcarbazepine. Serotonin–norepinephrine reuptake inhibitors. Vincristine .

What helps elderly with medication?

10 effective medication management tips for seniors Review your aging loved one’s medications with their doctor. Ask questions and read medication labels. Learn about possible drug interactions. Understand potential side effects. Ask if the dosage is age-appropriate. Be aware of medications deemed unsafe for seniors .

Why do elderly take so many medications?

Polypharmacy occurs when a patient takes too many medications for their own good. It is most common among seniors and individuals with multiple medical conditions. Since older people metabolize drugs differently, the combined effects of numerous medications can be especially harmful.

How many seniors require hospitalization due to medication problems?

About 350,000 patients each year need to be hospitalized for further treatment after emergency visits for adverse drug events. People typically take more medicines as they age, and the risk of adverse events may increase as more people take more medicines .

What is the best pain medication for the elderly?

For mild pain, the most appropriate first choice for relatively safe analgesia is acetaminophen . For mild to moderate pain or pain uncontrolled with acetaminophen , the use of NSAIDs is appropriate.

Why do elderly need high level of care?

Higher levels of care are for residents who need more hands-on assistance from caregivers. These residents may not be able to ambulate independently and need help walking or wheeling from one place to another. Residents need more extensive help dressing, bathing, or managing their toileting or incontinence.

How does polypharmacy affect the elderly?

The symptoms caused by polypharmacy is unfortunately usually demented with the normal aging signs and symptoms, which can be: Tiredness, sleepiness, or decreased alertness, constipation, diarrhea, or incontinence, loss of appetite, confusion, falls, depression or lack of interest in your usual activities, weakness,

What is the drug class commonly associated with adverse drug events in elderly patients?

Epidemiological studies have found that the classes of drugs most commonly associated with adverse drug reactions in the elderly include diuretics, warfarin, non-steroidal anti-inflammatory drugs (NSAIDs), selective serotonin reuptake inhibitors, beta-blockers and angiotensin-converting enzyme (ACE)-inhibitors.

Why are drug doses decreased for elderly patients?

Renal function may also be affected by the presence of a coexisting disease, which are common in the elderly . Decreased renal function, results in a reduction in drug clearance, older patients may therefore require lower or less frequent doses .

Which antidepressant should be avoided in the elderly?

Tricyclic antidepressants , especially amitriptyline and dothiepin ,¹⁶ are known to pose a high risk of death in overdosage. These drugs should therefore be avoided in older people whose medication is not supervised and who are at risk of taking an overdose.

What is the best antihistamine for the elderly?

The first-generation or “older” antihistamines (e.g., chlorpheniramine, diphenhydramine ) are effective in reducing sneezing, itching, and rhinorrhea. They have untoward side effects, however, that are particularly notable in the elderly patient.

What is the safest antidepressant for the elderly?

Choice of antidepressant The selective serotonin reuptake inhibitors (SSRIs) and the newer antidepressants buproprion , mirtazapine, moclobemide, and venlafaxine (a selective norepinephrine reuptake inhibitor or SNRI) are all relatively safe in the elderly.