1. Drug Therapy in Geriatric Patients
Chapter 11
Drug Therapy in Geriatric Patients

2. Drug Therapy in Geriatric Patients
Elderly patients constitute 12% of the population but use 31% of the nation’s prescribed drugs

3. Drug Complications in the Elderly
Contributing factors to drug complications are
Altered pharmacokinetics
Multiple illnesses
Multiple drug therapy
Poor compliance

4. Altered Pharmacokinetics
Absorption
Distribution
Increased percentage of body fat
Decreased percentage of body mass
Decreased total body water
Reduced concentration of serum albumin
Metabolism
Decreased hepatic metabolism
Excretion
Reduced renal excretion

5. Renal Excretion
In the elderly, the proper index of renal function is creatinine clearance, not serum creatinine

6. Adverse Drug Reactions
Seven times more likely in elderly
16% of hospital admissions
50% of all medication-related deaths

7. Monitoring for Adverse Drug Reactions
Take thorough drug history
Low dosing
Plasma level monitoring
Simplest regimen
Review drug treatment schedule

8. Promoting Compliance Simple drug regimen
Verbal and written instructions
Appropriate dosage form
Clear labeling
Daily reminders
Support system
Frequent monitoring