Use The Drug In The Elderly

Elderly people (considered to be 60 years of age or older) account for a very small proportion of the population (12%) but the amount of drugs used for this subject is not small (50% of medicines in general, of which by doctors appoint 1/3 of the drug is of the prescription type).
In particular, the incidence of drug-induced complications is more common in the elderly than in other age groups of 60. In the US, 1 in 6 elderly drug users is often mistaken for a reaction. Adverse Drug Reactions (ADR) causes physical and mental disorders, even death.
The common clinical manifestations in the elderly due to ADR of the drug (easily mistaken for disease): insecurity, falls, depression, confusion, cognitive disorders, constipation, uncontrollable urination , extrapyramidal syndrome, sexual dysfunction, insomnia

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Causes
Some causes of ADR increase in the elderly when taking the drug:
- Elderly people often get sick, not one but many diseases at the same time, so they often have to take more medicine than young people A number of studies in advanced countries show that people over 65 years of age are prescribed on average 5 to 6 drugs, and therefore are susceptible to drug interactions leading to ADR.




- Elderly people can see two doctors at a very short time and the second doctor does not know what drugs the previous doctor has appointed to recommend to stop using to avoid interacting with new drugs.
- Due to many diseases, not only acute illness but also chronic disease, these diseases sometimes require the use of many powerful drugs, a safe distance in narrow treatment, and easily cause ADR.
- Elderly people who are too worried about their health want to get better soon so they often take additional medicine in addition to the prescribed drugs or people who are not sick still take so-called "precautions" drugs.
Not even complying with the doctor's prescription, increasing the dose or prolonging the time taken, leading to an overdose that causes poisoning.
-In contrast, there are elderly people afraid of taking drugs because they think drugs are always harmful. Some people arbitrarily reduce the dose, some people reduce the number of times a day to use the drug (such as instead of taking 3-4 times, only take 1-2 times / day), some people stop giving up drugs midway.
Some studies show that up to 40% of elderly people stop taking the drug early, because of the difficulty of having to take it many times a day or combining too many drugs Early discontinuation can lead to catastrophic events (ADWEs: Adverse Drug Withdrawal Events).



Such as abruptly stopping the antihypertensive drug can make blood pressure spike very dangerous.
- In the elderly due to intellectual impairment, there is often confusion in the use of drugs, especially in terms of dosage and frequency of administration. In this case, it is necessary to have young relatives closely monitor the use of the drug, do not let the elderly take the drug on their own.
- Due to the aging process affecting the pharmacokinetics of the drug (i.e. affecting the absorption, distribution, metabolism, elimination of the drug) as well as the pharmacodynamic properties of the drug body, resulting in very unexpected and unhelpful reactions.
Principles of drug use in the elderly
To use the drug in the elderly effectively and safely, the following principles should be observed:
- Need to know the history of the elderly drug use at the examination (should carefully ask what they have used, including herbal medicines, functional foods or not).
- Physicians only prescribe medication when absolutely necessary and after an accurate diagnosis.




- In the elderly should start with the lowest effective dose, and should extend the frequency of taking the drug during the day appropriate (as for young people taking 3 times / day, for the elderly can use 2 times / day).
- Note the favorable conditions for adherence to the drug (choose the appropriate form of liquid medicine if there is a solution for oral administration, or the medicine used several times a day is a long-term release drug once a day) ...).
- Clearly guide the medication instructions clearly and ensure the adherence to the treatment with persuasive sympathetic words as well as spend time listening to the thoughts of the elderly.
- Monitor closely for a long time the response to the effects of the drug in the elderly. It is impossible to infer drug experience in young people for the elderly.



Stop taking the drug if the benefits are unknown or with ADR.
- Be very cautious when giving new drugs.
- Note the drugs to avoid the elderly in general and the elderly are suffering from a certain medical condition.
Note the drugs to avoid the elderly are suffering from a pathology:
- Do not use effervescent tablets for people with hypertension, heart failure (effervescent drugs always contain sodium will increase blood pressure).
- Avoid using beta-blockers for people with asthma, COPD, diabetes mellitus (beta blockers cover the symptoms of hypoglycemia in people taking antidiabetic drugs), peripheral vascular disease .
- Avoid using antihistamines, antispasmodics, antidepressants for people with benign hypertrophic gland.

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