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Related Experiment Videos

Drug therapy

P A Rochon1, J H Gurwitz

  • 1Baycrest Centre for Geriatric Care, North York, Ontario, Canada.

Lancet (London, England)
|July 1, 1995
PubMed
Summary

Prescribing medications for older adults presents unique challenges due to increased drug interactions and age-related physiological changes. Improving drug therapy in the elderly requires careful consideration of prescribing principles and enhanced knowledge sharing.

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Area of Science:

  • Geriatric pharmacology
  • Clinical pharmacy
  • Evidence-based medicine

Background:

  • Older adults use significantly more prescription medications than younger individuals, increasing the risk of drug interactions and adverse events.
  • Age-related changes in pharmacokinetics and pharmacodynamics necessitate cautious drug prescribing in the elderly population.
  • Specific drug examples like diazepam and digoxin illustrate altered drug concentrations due to age-related pharmacokinetic shifts.

Purpose of the Study:

  • To explore strategies for enhancing drug prescribing practices for older patients.
  • To address the scarcity of specific information guiding geriatric pharmacotherapy decisions.
  • To outline principles of prudent prescribing and identify knowledge gaps in elderly drug therapy.

Main Methods:

  • Review of existing literature and clinical guidelines on geriatric pharmacotherapy.
  • Analysis of age-related pharmacokinetic and pharmacodynamic alterations affecting drug efficacy and safety.
  • Discussion of prescriber-controlled factors in medication management, including drug selection, dosage, and duration.

Main Results:

  • Older individuals exhibit altered drug distribution and clearance, leading to potentially higher plasma concentrations.
  • Increased sensitivity to certain drug effects, such as opioids, is observed in the elderly population.
  • Physician decision-making regarding prescription initiation, drug choice, and administration is crucial for safe and effective therapy.

Conclusions:

  • Optimizing drug therapy in older adults requires a collaborative physician-patient approach to decision-making and adherence.
  • Further research and dissemination of knowledge are essential to improve prescribing for the elderly.
  • Adherence to prudent prescribing principles can mitigate risks associated with polypharmacy in geriatric patients.

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