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Medication monitoring in the elderly
1Department of Veterans Affairs Medical Center, Lexington, Kentucky 40511, USA.
Objective:
To review changes associated with aging that affect medication use and to outline medication-monitoring guidelines.
Data Sources:
Recent medical literature including journals and texts.
Study Selection:
Determined by the author.
Data Extraction:
By the author.
Data Synthesis:
There are many changes that occur in the aging individual that may affect medication use. Alterations in organ function, especially that of the liver and kidneys, may potentiate drug effects. Appropriate use of serum-drug concentrations, used in conjunction with standard clinical observations, is an effective means of monitoring the patient. Medications with a high risk of toxicity in the elderly, such as phenytoin, theophylline, and digoxin, may be used with a much higher degree of safety if serum concentrations are obtained. Blood samples must be obtained at appropriate times to ensure accurate interpretation of the drug concentration.
Conclusion:
When performed appropriately, serum-concentration monitoring of medications is a valuable method of reducing toxicity in the elderly.