Life span: Older adults

Diane S. Aschenbrenner

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

• Older adults share common age-related changes and risk factors that alter drug administration, dosage, and expected response to drug therapy. • Aging alters all of the pharmacokinetic processes, placing older adults at increased risk for adverse drug effects. • Serum creatinine levels often remain in the normal range despite impaired kidney function. • Pharmacodynamics of drug therapy may be decreased in older adults because of changes in the receptor systems. Older adults also have decreased amounts of the neurotransmitters dopamine and acetylcholine. • Some drugs or drug classes produce more adverse effects in the older adult, partly related to decreased organ functioning. Dose modifi cations and close clinical monitoring are necessary if these drugs must be used in older adults. • Many signs and symptoms of health problems in older adults result from the normal aging-related decline in organ or system function. These symptoms often mimic the adverse effects of drug therapy. The nurse must be careful to distinguish between the normal signs and symptoms of aging and the onset of adverse effects from drug therapy. • Three main concerns with drug therapy in older adults are polypharmacy, inappropriate drug prescription, and nonadherence with therapy. • Polypharmacy is an important concern in older adults because it greatly increases the risk of drug interactions and adverse effects • Inappropriate drugs are all too frequently included in the older adult's drug regimen. These drugs are described in the Beer's criteria; they increase adverse effects, emergency room visits, and hospitalizations for older adults. They are more likely to be prescribed if the patient is receiving polypharmacy. • Nonadherence with drug therapy is when a patient does not take a drug as prescribed but takes too much or too little of a prescribed drug. Multiple factors contribute to nonadherence such as forgetfulness, complexity of the drug regimen, cost of drug therapy, physical inability to open medication packaging, and inability to travel to the pharmacy. • Nurses can promote older patients' adherence to prescribed drug therapy by minimizing the use of drug therapy when possible, simplifying the therapeutic regimen as much as possible, titrating doses upward gradually as prescribed to minimize adverse effects, helping with drug administration scheduling, assisting with memory aids if needed, and providing teaching and instructions in writing. • Medication reconciliation will help to rectify inappropriate drug prescription, prevent drug interactions, and correct accidental overuse of a prescribed drug. • Nurses need to assess patients' circumstances and cultural preferences or barriers to determine whether patients have the means and ability to obtain and comply with prescribed treatments, dietary recommendations, daily routine, and activity levels that can affect drug therapy.

Original languageEnglish (US)
Title of host publicationDrug Therapy in Nursing
PublisherWolters Kluwer Health Adis (ESP)
Pages96-109
Number of pages14
ISBN (Electronic)9781469819174
ISBN (Print)9781451187663
StatePublished - Nov 7 2012

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Drug Therapy
Pharmaceutical Preparations
Polypharmacy
Inappropriate Prescribing
Drug Prescriptions
Nurses
Drug Interactions
Signs and Symptoms
Medication Reconciliation
Drug Costs
Aptitude
Prescription Drugs
Drug Monitoring
Product Packaging
Patient Compliance
Acetylcholine
Neurotransmitter Agents
Cations
Hospital Emergency Service
Dopamine

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Aschenbrenner, D. S. (2012). Life span: Older adults. In Drug Therapy in Nursing (pp. 96-109). Wolters Kluwer Health Adis (ESP).

Life span : Older adults. / Aschenbrenner, Diane S.

Drug Therapy in Nursing. Wolters Kluwer Health Adis (ESP), 2012. p. 96-109.

Research output: Chapter in Book/Report/Conference proceedingChapter

Aschenbrenner, DS 2012, Life span: Older adults. in Drug Therapy in Nursing. Wolters Kluwer Health Adis (ESP), pp. 96-109.
Aschenbrenner DS. Life span: Older adults. In Drug Therapy in Nursing. Wolters Kluwer Health Adis (ESP). 2012. p. 96-109
Aschenbrenner, Diane S. / Life span : Older adults. Drug Therapy in Nursing. Wolters Kluwer Health Adis (ESP), 2012. pp. 96-109
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