In the United States today, the elderly make up approximately 13% of the population but use 30% of all prescriptions written. On average, the elderly patient takes approximately four to five prescription medications and two over-the-counter medications. It is also likely that one of their prescribed medications is unnecessary, ineffective, or even potentially dangerous, and the patient suffers an adverse drug reaction (ADE). In a study of more than 150,000 elderly patients, 29% had received at least one of 33 potentially inappropriate drugs. A study of approximately 27,600 Medicare patients documented more than 1,500 ADEs in a single year. ( ) Most ADEs come from drug interactions. Therefore, the more drugs a patient takes, the more likely …show more content…
These changes affect what the body does to a drug, pharmacokinetics, and what a drug does to the body, pharmacodynamics. The three components of pharmacokinetics are absorption, distribution, and clearance, and each is affected by aging. Absorption is the least affected change. It is a slower process, but complete. If the absorption is the skin, it can actually increase as the skin is thin and frail. The more medications a patient takes, however, the higher the risk it will interfere with the absorption of another medication. Distribution of medication also changes with age. Medications are distributed into either fat or water, depending on its chemical characteristics. As a patient ages, their percentage of body fat increases, so a drug that is fat soluble may stay in the body longer because there are more fat stores. Because elderly patients have less body water than younger patients, blood levels of a water soluble medication would be higher than expected. It is also difficult to anticipate the effect that changes in fat stores or body water will have on drug distribution because other body functions, such as protein binding, can also complicate drug …show more content…
As the body ages, blood flow through the liver decrease, which reduces the clearance of certain drugs by 30%-40%. Alos, the major enzyme system by which the liver metabolizes drugs, P450, becomes easily overwhelmed, so certain medications are metabolized more slowly and not as well. The size of the kidneys and renal blood flow both decrease with age as well. Aging also affects pharmacodynamics. Changes to drug receptors can make a patient more or less sensitive to certain medications. Drugs that interact with the CNS may have a greater impact in an elderly patient than a younger as a result in changes in the blood-brain barrier. A good way to protect an elderly patient from polypharmacy is by knowing which drugs frequently cause problems in this age group. Many healthcare institutes use the Beers Criteria, a list of potentially inappropriate medications for the elderly, to evaluate the drug regimens of their patients. Another way to protect the elderly patient is to take a thorough drug history of the patient. Document and examine all medications the patient including prescription, over-the-counter, and herbal products. Confirm the names, generic and brand, the drug class, and the clinical indication are correct as ordered. Find out if the patient is seeing another health care providers and if they have prescribed medications
Pharmaceuticals have examined and found to ”work by changing the biological functions of the target cells in the body through chemical agents“ (Doweiko, 2015, p. 16). ”Many people in the past have thought that drugs that
...teract. Many of the medications are very powerful in and of themselves. This article also presents additional approaches to medicating the elderly, including focus on reduction of number of medications prescribed. Both articles present the importance of considering the normal physiological changes within geriatric patients.
When doctors prescribe medication for their patients, a local retail pharmacy is most likely to be utilized to fill the order. However, there is a growing population of older Americans that are no longer able to live independently and must reside in nursing homes or assisted living facilities. In order for this vulnerable population to receive their medications, a different kind of pharmacy is needed, these are known as LTC, long term care pharmacies. Within these specialized pharmacies there are highly trained employees called CPhTs, certified pharmacy technicians who are overseen by state licensed RPHs, otherwise known as pharmacists.
and previous spouses at age sixty-five. For the most part, the Medicare population consists of
There are profound effects of ageism that can be harmful to a patient’s overall health. Ageism can cause physicians to consistently treat older patients unequally compared to younger adults. Unequal treatment can be divided into the under-treatment of symptoms and the over-treatment of symptoms. The imbalance in how a physician would treat a geriatric patient is ageist because the older adult is not getting fair treatment in every case. Under-treatment and over-treatment are different; however, they are both equally as harmful to a patients health.
As we age, the use of medication is often increased in an effort to treat illness and disease. In older adults this frequently results in the administration of multiple medications, both appropriately and inappropriately, at the same time. This is known as polypharmacy. While polypharmacy can exist with any age demographic, it is much more prevalent in older adults where the risk of multiple health conditions is greater. It is not uncommon, for example, for a patient to be treated with multiple therapeutic drug combinations in order to manage disease such as diabetes, heart failure and chronic obstructive pulmonary disease (Kaufman, 2011, p. 49). Polypharmacy is associated as a major factor placing older adults at risk for an adverse drug event. As the number of medications increase, the need for monitoring becomes much more crucial. When there is a breakdown in proper monitoring, the older adult is significantly placed at a higher risk for negative health outcomes due to serious side effects, poor adherence, adverse drug reactions and adverse drug interactions.
Drug use appears to negatively affect the health of the elderly at a higher rate than other populations (Benshoff & Koch, 2003). This may be a result of old age. So, it can be understood there is a biological effect of substance abuse among the elderly. The elderly are more susceptible to being admitted into the hospital for adverse effects of substances, while other populations of society are not. Benshoff and Koch asserts, “Intentional abuse of prescription medications to get high is thought to be rare, but over-use does occur among this population. Often this over...
contamination, toxicity, and side effects. Most people believe these medications are compounded or mixed by a trained and licensed individual. However, this is inaccurate because the pharmacy technician actually compounds a large percentage of a patient’s medications. Compounding involves a techn...
Today, the world’s population is aging at a very fast pace and the United States is no exception to this demographic change. According to the U.S Census Bureau, senior citizens will account for 21% of the American population in 2050 (Older Americans, 2012). Although living longer lives may not seem like a negative sign, living longer does not necessarily mean living healthier. Older adults of today are in need of long-term health care services more than any generation before them (Older Americans, 2012). Because of the growing need for senior care, millions of families are facing critical decisions on how to provide care for their parents.
Thank you for that insightful post. As I mentioned in my post, the current deficit of geriatricians is projected to become more pronounced with expected growth of the elderly population. More geriatricians will be necessary to provide healthcare for this medically complex population. Several steps can be taken to increase the number of geriatric physicians including establishment of more geriatric departments in medical schools in the U.S., increase in the number of training positions for geriatrics and primary care as opposed to other medical specialties and increased reimbursement for physicians caring for the geriatric population. With regards to preventive care, there are already several recommended age appropriate screenings in place such
Routes of administrating a drug all depend on how the medication is delivered to the patient. The most common and most frequently
Aging brings on the experience of senescence a process of aging. This is a time where the body begins to become a bit weaker and less efficient. (Berger, 2014, p.576) Interestingly enough the physiological factors of aging actually protects adults. The heart and lung begin to lose the reserve capacity each part of the body begins to accommodate the changes that are happening in the other parts of the body. Whether or not a person is old or young the lungs still maintain the oxygen capacity. The brain does however slow down with age and even shrink a bit, but most of the time this goes unnoticed. If there are any severe losses before the age of 65 most often it is attributed to one of these four factors; drug abuse, poor circulation, viruses and genes. The outward appearance also changes skin becomes more wrinkled (unless of course you try Botox regularly) and hair gets grayer and thinner along with may other things. (p.579) The body senses begin to compensate for each other the sight with the hearing and the taste with the smelling. After age 50, it is almost impossible to be able to reproduce without extra hormones. Besides sexual arousal usually begins to slow down or even stop at or after age 60. (p.580-581)
As you age, cognitive change is a normal process. Abilities like reasoning, memory, and the speed you process something gradually decrease over time. The reason cognitive functions decrease are because your blood vessels narrow and become less stretchy. This might cause blood flow to the brain and other important organs to decrease. An elderly person's blood pressure may also get higher or lower.
Some of the physical changes that occur to the individual affect their health. As a result, the person may have some health issues. Sometimes, pharmaceutical interventions are necessary to maintain their health. However, many times the use of many medications, the time when to take them, and which food inhibit the absorption of the drugs become confusing for the elderly people. (The confusion about medications can happen to young and middle age people too!). As a result, someone may need to assist them
...otecting them from further dangerous exogenous substances, a price is later paid with a weakened dysregulated immune system, becoming susceptible to aging and age related diseases (DeVeale, Brummel & Seroude, 2004). Despite continued research into the complex aging process, humans are continually aging both physically and mentally. However, just as the immune system is a part of the complexity of the human being, so is aging (Effros, 2005).