drug therapy across lifespan- pharm

Is 41 pharmacodynamic changes in the elderly

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Unformatted text preview: ay be normal even though kidney function Creatinine is greatly reduced. is 41 Pharmacodynamic Changes in the Elderly Alterations in receptor properties may underlie altered Alterations sensitivity to some drugs. sensitivity • Drugs with more intense effects in the elderly 42 Predisposing ADR Factors Drug accumulation secondary to reduced renal Drug function function Polypharmacy Greater severity of illness Multiple pathologies Greater use of drugs that have a low therapeutic Greater index (for example, digoxin) index Increased individual variation secondary to Increased altered pharmacokinetics altered Inadequate supervision of long-term therapy Poor patient adherence 43 Polypharmacy • Longevity generally leads to increased illnesses. • Greatly increases the risk of drug interactions and adverse effects. • Result from simultaneously increased use of prescriptive and over-the-counter drugs. • Results from multiple disease processes and prescribing behaviors of health care providers. 44 Promoting Adherence with Unintentional Nonadherence Simplified drug regimens Clear, concise verbal and written instructions Appropriate dosage form Clearly labeled and easy-to-open containers Daily reminders Support system Frequent monitoring 45 Intentional Nonadherence Most cases (75%) of nonadherence are intentional. Reasons include: • Expense, side effects, patient’’s conviction that the drug is s unnecessary or the dosage too high unnecessary 46 Assessment of at-Risk Older Adult • • • • Complete drug history List of all medications taken by client List of all prescribers for client Review of prescription bottles for possible use of multiple pharmacies for prescriptions • Review of all medication expiration dates • Assessment of self-medication practices • Assessment of limitations to selfmedication 47 Patient Education • • • • • Review all medications with patient. Have patient repeat information. Time needed for learning often increases. Perform fun...
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This document was uploaded on 03/25/2014.

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