Sunday, January 15, 2006

medication, difficulties in prescribing

A number of factors make prescribing drugs for the elderly difficult.
They include:
1. Atrophy of Disuse-Many elderly people are forced into a sedentary, inactive lifestyle. Their functional ability is decreased by this disuse. Even though large tissue and organ losses do not always jeopardize life itself, they can greatly influence drug action.
2. Sex Difference-Females generally react to drugs differently than males.
3. Malnutrition-Poor eating habits and malnutrition are a common problem in the elderly, making drug therapy more complicated.
4. Chronic Drug Use-Little is known about the long-term effects of continued drug use. But it is established that chronic use of certain drugs may interfere with a patient's nutritional status.
5. Multimorbidity-Many elderly patients suffer from multiple physical problems and may be seen by several physicians. They also may patronize more than one pharmacy to have their prescriptions filled. Thus, one physician or pharmacist may not be aware if a drug is duplicated or if a potential negative interaction exists.
6. Diagnostic Difficulties-At times it is difficult to prescribe for the elderly because it is difficult to diagnose the problem.
Some symptoms that are often ascribed to old age (confusion, falls, fatigue) can be indicators of serious illness. The elderly frequently do not give a reliable history, by attributing many symptoms to age and failing to mention them to the doctor.
Covington, T., and Walker, J. Current Geriatric Therapy. Philadelphia: W. B. Saunders, 1984.

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