While the proportion of mental health problems is approximately the same for younger adults, older adults are more vulnerable than younger adults to develop psychological problems resulting from factors that impact the quality of life such as stress, ill health, loss, decline in cognitive skills, and changes in living situations.
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ABSTRACT: Depression in the elderly significantly affects patients, families, and communities. Awareness of predisposing and precipitating factors can help identify patients in need of screening with tools such as the Geriatric Depression Scale. On average, elderly patients have 6 diagnosable disorders, and the primary care physician is often unaware of some of them. A disorder in one organ system can weaken another system, exacerbating the deterioration of both and leading to disability, dependence, and, without intervention, death. An elderly male with dementia was admitted for increasing aggression and agitation. He was initially treated with risperidone, citalopram, and memantine, as well as nonpharmacological interventions such as behavioral approaches, environmental modifications, and .
Abstract In the past, polypharmacy was referred to the mixing of many drugs in one prescription. Today polypharmacy implies to the prescription of too many medications for an individual patient, with an associated higher risk of adverse drug reactions ADRs and interactions.
Situations certainly exist where the combination therapy or polytherapy is the used for single disease condition. Polypharmacy is a problem of substantial importance, in terms of both direct medication costs and indirect medication costs resulting from drug-related morbidity.
Polypharmacy increases the risk of side effects and interactions. Moreover it is a preventable problem. A retrospective study was carried out at Bhopal district Capital of Madhya Pradesh, India in the year of September-November by collecting prescriptions of consultants at various levels of health care.
The tendency of polypharmacy was studied and analyzed under the various heads in the survey. Available data suggests that polypharmacy is a widespread problem, and physician, clinical pharmacists and patients are all responsible.
These risks can be minimized through identifying the prevalence of this potential problem in a high-risk population and by increasing awareness among patients and healthcare professionals. Physicians and clinical pharmacists have the potential to combating this problem through a variety of interventions such as reducing the number of medications taken, reducing the number of doses taken, increasing patient adherence, preventing ADRs, improving patient quality of life and decreasing facility and drug costs.
These patients are much more likely to experience Polypharmacy and its negative consequences, especially ADRs. It comes from two Greek root words: It is generally used when that one person is taking too many medications, or when the drugs have been prescribed by many doctors, and may not have been coordinated well.
The definition of polypharmacy is still controversial. As the population ages, polypharmacy increases. The elderly often required multiple medications to treat multiple health-related conditions. It is not unreasonable for patient with multiple comorbid medical conditions to be on medications to reduce his or her long-term risk for those conditions, i.
Medicines are started and stopped quite frequently during patient hospital stay. Multiple doctors are prescribing medications for the same patient.
Once a patient starts a medication, it is never discontinued. Lack of patient education is the most common reason. Doctors do not inform patients or patients do not ask questions. Polypharmacy is associated with suboptimal and inappropriate prescribing.
Many medications that have an increased tendency to cause problems for older patients have been labeled as inappropriate drugs for this segment of the population. The simplest definition of an inappropriate drug is one that has greater potential to harm than to benefit the patient.
It is difficult to state that any given drug should not be used in an elderly patient under any circumstances. High-risk medications do not cause problems in all elderly patients, but they do have an increased potential to cause problems. Beers et al,[ 23 ] developed the following criteria for classifying a drug as inappropriate for use in elderly patients: Specific medications or classes of medications that should not be used routinely in elderly persons.
This may be due to lack of proven drug effect, a high likelihood of adverse drug effects, the potential for severe adverse effects, or a high potential for interaction with another drug or class of drugs.
Excessive dosages of medications used in elderly patients. Some medications for elderly patients are safe when used in lower doses but increase the risk of problems when used in higher doses.
Excessive dosing frequencies that would make compliance difficult for elderly patients. Because elderly patients tend to take multiple medications, it is best to prescribe medications that have once-daily dosing when possible.
Extended duration of use of medications that were intended to be used for a limited time. Some medications, prescribed initially for a limited time, become unnecessary and therefore inappropriate if taken for long term.
Polypharmacy may occur when additional drugs are prescribed to treat the adverse effects of other drugs.Managing Polypharmacy in the Elderly March 21, Barbara Farrell BScPhm, PharmD, FCSHP Pharmacist, Bruyère Geriatric Day Hospital. Objectives Participants will be able to: •Describe the impact of polypharmacy on patients and the health care system.
Older adults with polypharmacy are predisposed to drug- interactions. In a prospective cohort study of older hospitalized adults taking 5 or more medications, the prevalence of a potential hepatic cytochrome enzyme-mediated, drug-drug interaction was 80%.
Diabetes mellitus is a leading cause of death in the United States and is associated with microvascular and macrovascular complications.
Approximately million persons, or % of the U.S. population, have type 2 diabetes ().In , the total direct and indirect costs associated with diabetes in the United States were $ billion ().
Falls in older adults are a significant cause of morbidity and mortality and are an important class of preventable plombier-nemours.com cause of falling in old age is often multifactorial, and may require a multidisciplinary approach both to treat any injuries sustained and to prevent future falls.
Falls include dropping from a standing position, or from exposed positions such as those on ladders or. Polypharmacy is the concurrent use of multiple medications by a patient. Polypharmacy is most common in the elderly, affecting about 40% of older adults living in their own homes.
About 21% of adults with intellectual disability are also exposed to polypharmacy. Polypharmacy is not necessarily ill-advised, but in many instances can lead to negative outcomes or poor treatment effectiveness.
Hypertension Management and Dealing With Polypharmacy in Elderly Patients—A Report From the European Union Geriatric Medical Society Meeting.