Medicines in older people

Question 1

Thinking about pharmacokinetics, what do you know about prescribing drugs in the elderly?

Answer 1

Age reduces renal clearance

Many aged patients thus excrete drugs slowly, and are highly susceptible to nephrotoxic drugs

Question 2

What is the most common symptom of adverse drug reactions in the elderly?

Answer 2

Confusion

But also constipation, hypotension and falls

Question 3

What do you know about diuretics prescriptions in the elderly?

Answer 3

Diuretics are overprescribed in old age and should not be used on a long-term basis

Raise legs more, supporting stockings

Question 4

What do you know about NSAID use in the elderly?

Answer 4

Bleeding more common in the elderly and it’s more likely to be fatal

Opt for paracetamol in pain that cannot be relieved with reduction of weight

Question 5

What drugs commonly give adverse reactions in the elderly?

Answer 5

Antiparkinsonian drugs, antihypertensives, psychotropics, and digoxin

Question 6

What dose of digoxin causes toxicity in the elderly?

Answer 6

250 micrograms

Opt for 125 micrograms daily (62.5 micrograms in those with renal disease)

Question 7

What do you know about warfarin use in the elderly?

Answer 7

Need a lower dose compared to younger adults