Polypharmacy
Definition and Overview
• Polypharmacy refers to the concurrent use of multiple medications,
typically defined as the use of five or more drugs.
• It encompasses both prescription and non-prescription medications,
highlighting the complexity of managing multiple therapies.
• The elderly population is particularly affected, with significant
statistics indicating that nearly one-third of adults over 65 take more
than five medications.
Causes of Polypharmacy
• Multiple prescribers often contribute to polypharmacy, as patients
may see various specialists who prescribe medications without full
knowledge of other treatments.
• There is a fear among healthcare providers of being accused of
ageism or cultural bias, leading to over-prescription.
• Good intentions to manage side effects of one medication with another
can inadvertently lead to polypharmacy.
Clinical Consequences
• Polypharmacy is a primary predictor of adverse drug reactions
(ADRs), which can lead to significant health complications.
• Adverse drug events (ADEs) can result in increased hospitalizations
and healthcare costs, as well as cognitive and functional decline in
older adults.
• Prescribing cascades occur when new medications are prescribed to
treat side effects of existing medications, further complicating
treatment regimens.
Physiological Changes in the Elderly
, • Aging affects pharmacokinetics, including absorption, distribution,
metabolism, and elimination of drugs.
• Key changes include decreased gastric acidity, reduced liver mass and
function, and diminished renal function, which can lead to drug
accumulation and toxicity.
Definition and Overview
• Polypharmacy refers to the concurrent use of multiple medications,
typically defined as the use of five or more drugs.
• It encompasses both prescription and non-prescription medications,
highlighting the complexity of managing multiple therapies.
• The elderly population is particularly affected, with significant
statistics indicating that nearly one-third of adults over 65 take more
than five medications.
Causes of Polypharmacy
• Multiple prescribers often contribute to polypharmacy, as patients
may see various specialists who prescribe medications without full
knowledge of other treatments.
• There is a fear among healthcare providers of being accused of
ageism or cultural bias, leading to over-prescription.
• Good intentions to manage side effects of one medication with another
can inadvertently lead to polypharmacy.
Clinical Consequences
• Polypharmacy is a primary predictor of adverse drug reactions
(ADRs), which can lead to significant health complications.
• Adverse drug events (ADEs) can result in increased hospitalizations
and healthcare costs, as well as cognitive and functional decline in
older adults.
• Prescribing cascades occur when new medications are prescribed to
treat side effects of existing medications, further complicating
treatment regimens.
Physiological Changes in the Elderly
, • Aging affects pharmacokinetics, including absorption, distribution,
metabolism, and elimination of drugs.
• Key changes include decreased gastric acidity, reduced liver mass and
function, and diminished renal function, which can lead to drug
accumulation and toxicity.
