Prescribing Medications for Older Adults: Dealing with Obesity, Misuse, Polypharmacy and Adverse Drug Events!
Pp. 281-305 (25)
T.S. Dharmarajan and S. Davuluri
Aging trends reflect an older population characterized by increasing life
expectancy. Aging is characterized by diminished physiological reserves and increasing
co-morbidity, with outcomes tending to be worse in overweight and obese individuals.
Older adults and especially the obese are on a large number of medications; these
include prescribed and over the counter drugs. Providers require an understanding of the
principles of appropriate prescribing for alterations in age related pharmacokinetics and
pharmacodynamics. Body characteristics that influence drug actions include leaner
body mass and changes in fluid and lipid compartment status; overweight and obese
individuals therefore have altered kinetics and dynamics. Medications can cause both
weight gain and weight loss. Polypharmacy is a common issue in the older population.
The consequences of inappropriate prescribing and polypharmacy include adverse drug
events and reactions, likely resulting in unwanted outcomes and hospitalizations.
Prescribing medicines for obese individuals imposes challenges. Medication
management must adopt principles to ensure adherence, surveillance, reconciliation and
cost containment, with the aim to maintain quality of health care as well as safety.
Adverse drug events, adverse drug reactions, drug interactions, drugdrug
interactions, drug-nutrient interactions, drugs and weight changes,
medication adherence, medications and metabolic syndrome, obesity and
medication effects, pharmacodynamics, pharmacokinetics, pharmacology of
aging, polypharmacy, potentially inappropriate medications (PIMs) potentially
inappropriate medications, principles of prescribing, renal function and
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