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Polypharmacy

Polypharmacy. Skills Workshop M1 Aging Week November 2012. Objectives. Discuss basic principles for safe prescribing for elderly patients. Describe the categories of medications most likely to cause adverse reactions or drug interactions for the elderly. Why worry about this in the elderly?.

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Polypharmacy

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  1. Polypharmacy Skills Workshop M1 Aging Week November 2012

  2. Objectives • Discuss basic principles for safe prescribing for elderly patients. • Describe the categories of medications most likely to cause adverse reactions or drug interactions for the elderly.

  3. Why worry about this in the elderly? • They are prescribed more medication • More medication= more drug interactions • Body changes with aging: • Decreased renal function • Higher proportion of body fat • Changes in liver metabolism

  4. Adverse Drug Reactions- Risk Factors • >6 concurrent chronic diagnoses • ≥12 doses of medications/day • ≥9 medications • Previous adverse reaction • Low body weight • Age >85 • Creatinine clearance <50 ml/min Geriatrics Review Syllabus- American Geriatrics Society

  5. Use with caution: • Antihypertensives/diuretics • Antiarrhythmics • Psychoactive medication (benzodiazepines, antipsychotics) • Narcotics • NSAIDs • Anticholinergics (Benadryl/Diphenhydramine, oxybutinin)

  6. Principles of prescribing • Start low and go slow! • Do benefits outweigh risks? • Before starting a medication for a symptom- is it a side effect of a drug? • Will there be drug interactions? • Does the patient understand how to take the medication?

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