PHAR4811 Lecture Notes - Lecture 7: Polypharmacy, Pharmacodynamics, Adverse Drug Reaction
23 Jul 2018
School
Department
Course
Professor
Document Summary
Sensible prescribing of cardiovascular drugs to older people. Older people are a special group clinically as they have multiple diseases, geriatric syndromes, which lead to polypharmacy and adverse drug reactions. In terms of physiology, they have less homeostatic reserve and pharmacokinetic and pharmacodynamic changes. Hospital admissions codes as secondary to adrs in wa. 40% not reviewed with professional for over 6 months. In australian nursing homes the average number of drugs was 6. 6 (range 0- Reduced homeostatic function reduction in organ function altered pharmacokinetics altered pharmacodynamics . Multiple diseases multiple prescribers multiple medicines poor adherence adverse effects. In trials, only 3% of randomized, controlled trials and 1% of meta-analyses, which are published, include people over 65 years. Evidence from older frail people"s" rcts - hard to find. Evidence from younger people"s" rcts: observational epidemiology. 82-year-old female, married lives independently, active, looks after grandchildren. On a routine visits bp is elevated on 3 different occasions.
