Clearing up the confusion: adverse effects of medications in the elderly

[Use of medicines by the elderly in a Family Health Program unit in Brazil]

The use of multiple medicines is frequent among the elderly. Although such practice is usually necessary, it predisposes to risks of adverse events and drug interaction. The present study was intended to verify the characteristics of medication among the elderly in relation to socio-demographic profile, the most commonly used drug classes, and treatment adherence. This was a descriptive study that included 301 elderly in the coverage area of a Family Health Program, using a previously structure home interview. The sample was predominantly female, with a high illiteracy rate and alterations in cognitive status and various forms of dependency. The subjects showed an average of 2.5 diagnoses and used 2.9 drugs per individual. Some of the drugs are classified as high-risk for the age bracket. Treatment adherence data showed dependence on others for administration, self-medication, forgetfulness in relation to medication, and insufficient knowledge of the drugs taken. Systematic follow-up is needed for elderly persons using multiple medicines, in addition to encouragement for non-pharmaceutical measures and an emphasis on educational measures for lifestyle change, backed by a multidisciplinary team.

Benzodiazepine-induced persisting amnestic disorder: are older adults at risk?

Currently there are approximately 31.5 million Americans 65 years and older. This number is expected to reach 39.3 million by 2010. This group represents 12% of the population, however, they use 25% to 40% of the prescription medications, averaging 4.5 medications daily; 75% of them use over-the-counter medications as well. This population has also experienced an increase in the prescription of central nervous system (CNS) medications. Benzodiazepines are the most widely prescribed class of CNS antianxiety/sedative medication. This article examines the use of benzodiazepines in relation to physiological, pharmacokintic, and pharmacodynamic changes of the older adult. The amnestic properties of these drugs in relation to the already decreasing cognitive function of the older adult are explored in relationship to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for substance-induced persisting amnestic disorder.

Effects of drug therapy on renal function of healthy older adults

1. The most significant action nurses can implement to prevent renal insufficiency in older adults is to encourage an increase in fluid intake. 2. NSAIDs, including aspirin, reduce the effectiveness of virtually all anti-hypertensive drugs through their sodium retention effects, which blunt the action of the anti-hypertensive drugs. 3. People aged 60 and older are considered at increased risk for nephrotoxicity due to the decline of glomerular filtration rate with age.

Minimizing effects of low literacy on medication knowledge and compliance among the elderly

Medication knowledge and compliance among the elderly was examined using a color-coded method, which was designed to tailor the medication regimen to the person's daily schedule. Data were collected from 80 elderly, predominantly indigent, and individuals of low literacy. Group 1 of the study received verbal teaching only, whereas Group 2 received verbal teaching and a color-coded medication schedule. Knowledge increased significantly among both groups. Compliance to the medication schedule increased in Group 2, among those subjects whose pretest compliance scores were low. These results suggest that a method that considers the characteristics of the individual can significantly increase knowledge and compliance.