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There are several important changes in pharmacokinetics metabolism associated with aging that predispose the elderly to increased risk of druginduced side effects including cardiac arrhythmia.
First, advanced age is accompanied by a decrease in overall body weight, total body water, lean body mass, and intravascular volume, resulting in a greater volume of distribution (V d ), which is defined by the drug dose divided by drug plasma concentration (V d = dose/concentration). The reduced distribution volume will, therefore, lead to a higher drug concentration after a given dose in the elderly compared to the younger population. (more…)
Complications of Adverse Drug Reactions may include hospitalization, increased hospital stays and health care expenditures, morbidity, and death. The incidence of Adverse Drug Reactions varies by type of health care setting (e.g., ambulatory clinic, hospital, nursing home). In a cohort of older Medicare enrollees, the rate of Adverse Drug Reactions was 50.1 per 1,000 person years. In long-term care facilities, the rates of Adverse Drug Reactions were reported as 1.9 to 9.8 per 100 resident-months. Adverse Drug Reactions are a common cause of hospital admission of older adults and were responsible for 6% to 24% of all hospital admissions. Of all Adverse Drug Reactions, 23% to 28% were categorized as serious.
Approximately one quarter to one half of Adverse Drug Reactions are considered to be preventable. Errors are most likely to occur at the time of prescribing a medication or during monitoring of therapy. Prescribing errors include choosing an inappropriate medication, prescribing a medication that interacts with another medication in the individual’s regimen, and prescribing a drug in the face of an established drug allergy. Errors in monitoring of therapy may include failing to obtain necessary laboratory values to monitor drug therapy and not responding promptly to signs, symptoms, or laboratory evidence of drug toxicity.
Many researchers have attempted to identify risk factors for Adverse Drug Reactions, an endeavor that has been disappointing. The most persistent risk factor for Adverse Drug Reactions is use of multiple medications; thus, it is important that patients be maintained on the fewest number of medications needed to manage their health conditions. Researchers have not found Adverse Drug Reactions to vary substantially according to age or sex. Several factors are important to keep in consideration to minimize Adverse Drug Reactions, even though they have not been identified as independent risk factors. (more…)
Osteoporosis is disease affecting the bones, making them fragile and prone to fracture. Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioraton of bone mass tissue, with a consequent increase in bone fragility and susceptibility to fracture. Osteoporosis is a condition characterized by mass loss of the normal density of bone. (more…)
