Question

The older population is prescribed more medications than any other age group. Outline a safe prescribing strategy to maximize benefit and minimize harm. What medications should be avoided and where would you find that criteria.

Answer 1

Ans) The statistics on medication usage among elderly patients in the US are eye-opening: more than one-third of prescriptions drugs used in the US are taken by elderly patients; the ambulatory elderly fill between 9-13 prescriptions a year (including new prescriptions and refills).

To prescribe safe medication strategy:

Provide information and education to the patient and their carer(s).

Assess the most appropriate route of administration.

Start with a lower dose for most drugs and titrate slowly.

Consider individual factors, e.g. renal function, alcohol intake, body fat, diet, cigarette smoking.

Consider practical factors such as packaging and dose scheduling.

Drugs to Be Used With Caution in Older Adults (Based on the American Geriatrics Society 2015 Beers Criteria Update)
Carbamazepine.
Carboplatin.
Cyclophosphamide.
Cisplatin.
Mirtazapine.
Oxcarbazepine.
Serotonin–norepinephrine reuptake inhibitors.
Vincristine.