Safe Medication Use for Elderly People

Subject: Geriatric Nursing (Theory)

Overview

Drug pharmacology is the study of how various medications work in the body. This topic is also known as "what the medicine does to the body," or pharmacokinetics. Some older persons may experience adverse effects from using the above medications, however, this is not always the case. Clinicians can reduce the risk of drug-related adverse drug effects in the elderly by following these steps before and after starting a new drug. Homeopathy, naturopathy, chiropractic, energy medicine, Old Chinese Medicine, Ayurveda, and Christian faith healing are just a few examples of alternative treatments available today. Chiropractic care, acupuncture, massage treatment, deep breathing exercises, herbal remedies, and meditation were all questioned in the poll. Around 43% of respondents had seen a chiropractor, making it the most popular type of alternative treatment. The practice of acupuncture was among the least popular.

Elderly people might respond differently to different types of medication. Therefore, it is necessary to adapt safe medication practices for elderly people.

Pharmacokinetics

Pharmacokinetics is the study of how a medication is absorbed, distributed, biotransformed (metabolized), and excreted.

What the body does to the body is the literal translation. It involves researching how medicines go from the point of administration to the place where they're needed.

  • Absorption of drugs
  • Distribution of drug
  • Plasma concentration of a drug
  • Metabolism of drug
  • Excretion of drug

Pharmacodynamics

Pharmacodynamics is the scientific study of how medications work biologically. Drug pharmacology refers to the scientific investigation of how various medications work in the body. This topic is also known as "what the medicine does to the body," as research into its mechanism of action and its effects falls under this umbrella term.

  • Action on specific receptors
  • Action on specific enzymes
  • Dose of drugs
  • Factors affecting response to drugs

Promoting the safe use of drugs

Make sure to document the use of any and all medications, including prescribed and over-the-counter. Also included are vitamins and other nutritional supplements commonly taken by the elderly. Jot down the dosages and bring them with you when you see a doctor. By keeping track of all prescriptions and supplements, both the patient and their loved ones may evaluate the potential for drug interactions and identify potential sources of unwanted side effects.

Identify the drugs known to cause adverse reactions and describe them. Give them a heads-up on the potential negative consequences by detailing them. Any adverse medication reactions should be reported to a doctor. It's important to talk to a doctor before you stop taking any drugs.

Any medication used should be included in AGS Beers Criteria; however, this does not automatically imply that there are more potential harms than benefits. A person's reaction to a medicine or combination of medications may vary from person to person. Because of this, the experts who revised the criteria used the term "possibly unsuitable." Some older persons may experience adverse effects from using the above medications, however this is not always the case.

Before starting a new drug:

  • To reduce the risk of adverse drug effects in the elderly, clinicians should do the following before starting a new drug:
  • Consider nondrug treatment.
  • Discuss goals of care with the patients.
  • Document the indication for each new drug (to avoid using unnecessary drugs)
  • Consider age-related changes in pharmacokinetics or pharmacodynamics and their effect on dosing requirements.
  • Choose the safest possible alternative (eg, for noninflammatory arthritis acetaminophen instead of an NSAID)
  • Check for potential drug disease and drug-drug interactions
  • Start with a low dose
  • Use the fewest drugs necessary
  • Note coexisting disorders and their likelihood of contributing to adverse drug effects
  • Explain the uses and adverse effects of each drug
  • Provide clear instructions to patients about how to take their drugs (including generic and brand names, the spelling of each drug name, indication for each drug, and explanation of formulations that contain more than one drug) and for how long the drug will likely be necessary
  • Anticipate confusion due to sound-alike drug names and point out any names that could be confused (eg, Glucophage and Glucovance)
  • After starting a drug
  • The following should be done after starting a drug:
  • Assume a new symptom may be drug-related until proven otherwise (to prevent a prescribing cascade)
  • Monitor patients for a sign of adverse drug effects, including measuring drug levels and doing other laboratory tests as necessary.
  • Documents the response to therapy and increases doses as necessary to achieve the desired effect.
  • Regularly reevaluate the need to continue drug therapy and stop drugs that are no longer necessary.

Alternatives to drugs:

Any treatment that claims to be beneficial but is not backed by scientific evidence is considered an alternative medicine practice. There is a huge variety of services, supplies, and treatments available in the health care industry. Homeopathy, naturopathy, chiropractic, energy medicine, Old Chinese Medicine, Ayurveda, and Christian faith healing are just a few examples of innovative and traditional medical methods.

Insights from the University of Michigan's Health and Retirement Survey of 2000, which received primary funding from the National Institute on Aging. There were 848 people over the age of 50 who participated in the study. Chiropractic care, acupuncture, massage treatment, deep breathing exercises, herbal remedies, and meditation were all questioned about in the poll. Around 43% of respondents had seen a chiropractor, making it the most popular type of alternative treatment. The practice of acupuncture was among the least popular. Chiropractic is a branch of medicine focused on the diagnosis, treatment, and prevention of neuromusculoskeletal problems and their consequences on a patient's overall health.

  • Reason for using alternative medicine
  • Disillusionment with conventional medicine when that offers no firm answers.
  • Dissatisfaction with a conventional practitioner who may exhibit poor communication, lack of empathy, and limited time.
  • Desire for simplicity, without complex directions, warnings, and labels.
  • The perception that natural medicines are more compatible with health and promote 'optimum health.
  • Ready access via the internet, health food shops, free calls hotlines, mail orders, and home delivery.
  • Enticing advertisement
  • A desire for autonomy over health care decisions.
  • As age, our hearts become weaker and often require a boost from some form of medication for high blood pressure, heart disease, etc. An alternative to these prescribed medications could be the use of omega 3 capsules (fish oil), known to not only aid in the lowering of blood pressure but also help build a strong heart and vascular system.
  • Eastern medication has offered the west the use of acupuncture. It is a means of controlling the flow of energy in the body. This treatment is primarily considered non-invasive in nature (even though very thin needles are utilized, it is not a surgical procedure by any stretch of the imagination). Combine this with Chiropractic treatments. The realigning of the body's skeletal system through manipulation of those parts then restores the proper nerve functioning and you now have yet another non-invasive alternative to surgery.

A third alternative form of treatment is massage therapy. In this form, it is the hope that stress will be reduced and that circulation will be improved, both of which should help to alleviate heart-related problems, such as hypertension.

Things to remember
  • Identify the drugs known to cause adverse reactions and describe them.
  • Any adverse medication reactions should be reported to a doctor.
  • To reduce the risk of adverse drug effects in the elderly, clinicians should do the following before starting a new drug: Consider nondrug treatment.
  • There is a huge variety of services, supplies, and treatments available in the health care industry.
  • Insights from the University of Michigan's Health and Retirement Survey of 2000, which received primary funding from the National Institute on Aging.
  • There were 848 people over the age of 50 who participated in the study.
  • Chiropractic care, acupuncture, massage treatment, deep breathing exercises, herbal remedies, and meditation were all questioned in the poll.
  • Around 43% of respondents had seen a chiropractor, making it the most popular type of alternative treatment.

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