A solution may lie in comprehensive geriatric assessment by pharmacists, regardless of the clinical setting. In addition, several prescribers may be involved in the care of a patient. Int J Pharm Pharmaceut Sci. To achieve these goals, it is necessary that all healthcare professionals understand the concept of functional status. In general, older adults present with weakness, confusion, syncope, and abdominal pain; however, electrocardiographic findings are similar to those in younger patients. Interactive technology is available in some areas to supervise, remind, and monitor drug adherence. In 2008, they made up 35% of hospital discharges while accounting for only 13% of the total population.
This technology has not undergone extensive scientific analysis. Maryland: American Society of Health-System Pharmacists; 2010. Studies of inappropriate drug use in U. All elders experience increasing vulnerability as they age, resulting in considerable heterogeneity in health states and care requirements. Useful features throughout the book guide practitioners in navigating the maze of information required when caring for an older patient. Among the older men studied, 56.
For example, the absorption of many fluoroquinolones eg, ciprofloxacin is reduced when they are taken with divalent cations such as calcium, magnesium, and iron, which are found in antacids, sucralfate, dairy products, or vitamins. One important factor for healthy aging is regular physical activity, which has many positive health benefits, including disease reduction e. Featured Titles: Click on a title below to see sample chapters and other valuable resources. Studies reveal that older adults reduce prescription medication use when they enter the gap. Trauma and musculoskeletal system dysfunction in the critically ill elderly population Felix Y. Disability rates have declined since the 1980s, with significant declines over the 1990s.
Gopinath S, Rajalingam B, Sriram S, Vijayakumar S. Tissue perfusion may decrease with aging, slowing the distribution to less highly perfused tissues such as muscle and fat. This text is unique, not only as a comprehensive overview of major issues in geriatric pharmacotherapy and a core textbook for students, but as a resource for all healthcare professionals who treat elderly patients. Drugs are the most common treatment for acute and chronic diseases. Welcome to Pharmacotherapy Online Written by the brightest, most respected minds in the field, McGraw-Hill's Pharmacotherapy titles are an unsurpassed way to learn the essential principles and latest clinical approaches to the treatment of diseases through the use of drugs. Immune response and infections in the elderly Nicole Bryan and Arif R.
Before starting a combination product, it needs to be determined that both medications are necessary and that the fixed doses in the product are appropriate for the patient. Nutritional and metabolic derangements in critically ill elderly Arturo G. Medication nonadherence has been implicated in approximately 4% to 11% of hospitalizations and 8% of emergency department visits. To my knowledge this is the first textbook that broadly covers pharmacologic as well as psychosocial and ethical issues unique to the geriatric patient for an audience that is not specialized in the area of geriatrics. A national survey reported that half of community-dwelling older adults take one or more over-the-counter drug products and one or more dietary supplements. However, given the intended audience that would benefit most from the use of the book, the amount of detail is sufficient. If you previously purchased this ebook please delete your current ebook file for this title.
Some hepatically metabolized medications can yield active, primarily renally excreted metabolites, such as N-acetylprocainamide, normeperidine, and morphine-6-glucuronide, which can accumulate with advancing age because of reduced renal function. However, as they age in the community, the likelihood of living alone increases, more so for women than men. The effects of aging have been studied to a greater extent on kidney function than on liver function. Fundamentals of Geriatric Pharmacotherapy: An Evidence-Based Approach gives practitioners the information they need to improve outcomes and personalize care for elderly patients. Explicit criteria for determining potentially inappropriate medication use by the elderly. Most, but not all, studies have reported reduced liver size and enzyme content in older adults.
Because there are many possible reasons for nonadherence, there is no simple screen. In busy practices, the approach outlined may not be feasible for every patient. Highlighting the vulnerability of frail older populations, Hanlon et al. Procurement issues related to affordability is a significant barrier to adherence in the elderly. The flexibility of the text and use of case discussions and key points at the end of the chapters makes it ideal for self-study. Factors such as inappropriate prescribing, insufficient monitoring of therapy, and lack of collaboration contribute to the increased risk.
In addition, nonadherence could be defined more than one way, including not filling the prescription primary nonadherence , discontinuation of the medication before the entire supply is consumed, or taking more or less of the medication than stated by the label. The case histories illustrate the complexity of treating these patients in different clinical settings and the decisions that have to be made to ensure that good pharmaceutical care is maintained. Adverse drug reactions in the elderly. The proportion of the population age 65 and older is increasing. Principles of geriatric pharmacotherapy John W.