This post collects different PowerPoint presentations on geriatric pharmacology. Some topics are recurrent, such as: physiological changes in pharmacokinetic parameters (absorption, metabolism, elimination), the concept of polypharmacy and classes of drugs that carry a higher risk of use in the elderly.
Geriatric drug therapy. By Linda Farho, Pharm.D
- Pharmacokinetics recall: Absorption, Distribution, Metabolism, Elimination. Bioavailability.
- Effects of Aging on: absorption, metabolism, volume of distribution and the kidney.
- Estimating GFR in the Elderly.
- Determining creatinine clearance.
- Concepts related to an optimal pharmacotherapy.
- Consequences of overprescribing.
- Adverse drug events (ADE): most common medications, Beers criteria, patient risk factors for ADE.
- Drug – drug interactions (DDI).
- Drug – disease interactions.
- Principles of prescribing in the elderly.
- Preventing polypharmacy.
- Enhancing medication adherence.
- Clinical cases.
Clinical Pharmacological Issues in the Elderly. By Charles A. Cefalu, MD
- Factors related to adverse drug reactions.
- Changes of aging: liver, renal clearance, CNS.
- Normal physiological changes in the organ systems.
- Pharmaceutical agents that require hepatic metabolism.
- The cytochrome system.
- Drugs eliminated in the kidneys requiring dosage adjustment.
- Aminoglycoside dosing in the elderly with impaired renal function.
- Practical rule of thumb for dose adjustment.
- Anticholinergic agents.
- Clinical conditions that necessitate dosage adjustment in the elderly.
- Anorexia and aging.
- Screening for potential toxicity of prescription drugs: H2 blockers, beta blockers.
- Innapropriate drugs: anticholinergics, indomethacin, propxyphene, trimethobenzamide and many others.
The Bagful of Pills: Polypharmacy in the Elderly. By Oana Marcu, DO
- Definitions: polypharmacy, adverse drug reaction.
- Economic consequences.
- Geriatric prescription principles.
- High risk medications in the elderly: Beers and Canadian criteria as consensus data.
- High risk medications: analgesics (NSAIDs, narcotics, muscle relaxants) and narrow therapeutic index (digoxin, phenytoin, warfarin, theophylline, lithium) cardiovascular (antihypertensives, calcium channel blockers, propanolol, diuretics – see indications and mechanism of action– ), psychotropics (TCAs, antipsychotics, benzodiazepines , sedatives).
- Avoiding polypharmacy: adjust the dose, review regimen regularly, educate.
- Personal Health Records.
- Clinical cases.
Polypharmacy in the Elderly. By Rosemary D. Laird, MD
- Overview of polypharmacy.
- The brown Bag.
- Medications and the elderly.
- Polypharmacy and the non-adherence.
- Adverse drug reactions.
- The role of the PCP.
- Prescribing pearls.