Drug therapy elderly patients

Elderly Use cautious dosage selection for an elderly patient, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant or other drug therapy. Elderly patients may be at an increased risk of adverse reactions compared with younger individuals. 

Therapists who are treating patients with Parkinson disease usually wish to coordinate the therapy session with the peak effects of drug therapy. In patients receiving levodopa, this usually occurs approximately 1 hour after a dose of the medication has been taken. If possible, scheduling the primary therapy session in elderly patients after the breakfast dose of levodopa often yields optimal effects from the standpoint of both maximal drug efficacy and low fatigue levels. 

Within the medical community it has been acknowledged that elderly patients often respond to drug therapy differently from their younger counterparts. Aside from alteration of various pharmacokinetic and pharmacodynamic processes, elderly patients tend to suffer from a number of chronic conditions and, thus, have more complex dosage regimens. Additionally, a variety of physical limitations prevalent among the elderly may hinder their ability to self-administer medication. 

Of considerable importance is the possibility of collecting data on other clinical conditions the patient may have and other drugs that may also be prescribed. It must be emphasised that the elderly are the largest users of drug therapy, they frequently suffer from more than one pathology and they are consequently often being... 

Hypertensive crises The most serious reactions involve changes in blood pressure it is inadvisable to use these drugs in elderly or debilitated patients or in the presence of hypertension, cardiovascular, or cerebrovascular disease. Not recommended in patients with frequent or severe headaches because headache during therapy may be the first symptom of a hypertensive reaction. 

Eideriy Exercise caution in elderly patients who may have a greater frequency of decreased renal or cardiac function caused by concomitant disease or other drug therapy. 

Saudek CD, Hill GS. Feasihihty and outcomes of in-suhn therapy in elderly patients with diabetes meUitus. Drugs Aging 1999 14(5) 375-85. 

Because of its anticholinergic properties, disopyramide should not be used in patients with glaucoma. Urinary retention and benign prostatic hypertrophy are also relative contraindications to disopyramide therapy. Patients with myasthenia gravis may have a myasthenic crisis after disopyramide administration as a result of the drug s local anesthetic action at the neuromuscular junction. The elderly patient may exhibit increased sensitivity to the anticholinergic actions of disopyramide. 

SaudekCD, Golden SH. Feasibility and outcomes of insulin therapy in elderly patients with diabetes mellitus. Drugs Aging i999 i4 375-385. 

Rajagopalan R, Perez A, Ye Z, et. al. Pioglitazone is effective therapy for elderly patients with type 2 diabetes mellitus. Drugs Aging 2004 21 259-271. 

The book concludes with Chapter 13 and Chapter 14 on disorders that require separate consideration. The first group includes Panic, Obsessive-Compulsive, Post-Traumatic Stress, Somatoform, and Dissociative disorders. Although traditionally these are classified as anxiety disorders, their symptoms and varied treatment responsivity require a separate series of discussions. Finally, certain groups of patients are considered in light of their specialized needs when contemplating psychotropic drug therapy. They include the pregnant patient, children and adolescents, the elderly, the personality disordered, as well as patients whose conditions are complicated by medical problems (e.g., the alcoholic patient the HIV-infected patient). 

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