Answers
How to avoid adverse drug interactions with the elderly?
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-Always prescribe the lowest dose possible
-We need to simplify the drug regimens, clear and concise verbal and
written instructions, appropriate dosage form, clearly labeled and easy-
to-open containers, daily reminders, a support system, and frequent
monitoring
Polypharmacy definition:
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-is taking five or more medications, and more drugs given or taken that
are relevant to a patient's chronic condition
PIMs
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are those without an evidence-based indication, those that have
potential for adverse effects with other medications the patient may be
taking, those that are continued beyond therapeutic benefit, or those
given in place of less expensive options.
,appropriate pharmacology
(Ans- optimization of medications in patients with complex and/or
multiple conditions, where medicine usage agrees with best evidence
Deprescribing
(Ans- the systematic process of identifying and discontinuing drugs in
instances which existing or potential harms outweigh existing or
potential benefits within the context of an individual patient's care
goals, current level of functioning, life expectancy, value and
preferences
risk factors, and polypharmacy
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Older patients also tend to have multiple subspecialist providers and no
primary care providers, and this makes them particularly vulnerable to
polypharmacy
-Living in long-term care facility
-have multiple medical and cognitive issues
healthcare system issues that contribute to polypharmacy
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-such as poor record keeping
-not reconciling meds at every visit, and auto refills.
, -Patients should be asked to bring all medications, including over-the-
counter medications, in their original containers to every office visit.
Automatic Refills
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they may not know to stop the medication if the pharmacy is continuing
to refill them.
Overmedicating
Wrong medications and should have stopped
Age-dependent changes in body composition: is one of the problems
with polypharmacy because as we age
-there is a substantial ---- in body fat, with
-a commensurate ------- in lean body mass,
-plasma volume levels =------ slightly,
total body water-----, and this
is in part due to ------ in lean body mass, and --------extracellular fluid
decreases up to 40%.
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-increase