The elderly are particularly vulnerable to drug side effects. To prevent accidents, it is necessary to limit the length of orders and to observe certain precautions.
Rheumatism, hypertension, sleep disorders, diabetes, osteoporosis, pain … with age, prescription longer. They will sometimes involve up to half a dozen treatments, if not more at risk to cause accidents toxic. Nearly half the drugs are consumed in France by people over 60 years.
In return, 10% of hospitalizations of elderly people are linked, at least in part, to a medical accident.
Bodies Underperforming
Several factors make the elderly more susceptible to the risk of medication errors, that is to say the side effects of treatment.
* The liver and kidney, the two bodies to ensure the degradation and elimination of drugs are less effective with age. Consequently, the chemical molecules remain longer in the blood and tissues before being eliminated and may accumulate over the catch. Doses well tolerated by young people can cause toxic effects in older people.
* The drugs are distributed differently in the body of the elderly. In fact, muscle mass and water in the body decreases with age, while body fat increases. Thus, drugs that dissolve in water (called water-soluble) will see their levels (and therefore their effects) in the blood increased, while soluble will be stored in fatty tissues.
* Some drugs enhance the effects of other molecules or alter their metabolism. These interactions are difficult to manage, is one of the major drawbacks of multiple treatments.
* Malnutrition and dehydration are common in the elderly. They increase the concentration and toxic effects of drugs.
* The toxicity of drugs to certain organs is more important than they are already the site of lesions. This explains why many complications are more frequent with age.
* Falls are a significant risk to the elderly. They are favored by many drugs, including sedatives and antihypertensives.
* The proliferation of drugs and changes in treatment are an obvious factor of poor monitoring and error. The risk is even greater among the elderly, which combines the difficulties associated with taking multiple medications for a memory and less powerful.
Make a choice
Some precautions can reduce the risk of accidents.
* During any consultation, it is essential to specify the doctor already prescribed medications.
* A hierarchy should be established between the different treatments, and retain only those with proven efficacy and are really necessary. Some drugs have little risk of overdose, but they increase the risk of errors or discouragement, for a doubtful benefit. It is estimated that 25% of prescriptions are ineffective and irrelevant.
* Concerning the so-called comfort drugs, if the order is growing dangerously, a choice must be made with the doctor to keep only those that significantly improve the quality of life.
* When choosing a treatment, physicians should emphasize the extent possible, the one with the largest margin between therapeutic and toxic effects and avoid those with a slow elimination and may accumulate in the organization.
* Doses should consider the weight and age of the person. For chronic treatments, it is often useful to start low dose and gradually increase the dosage until the desired therapeutic effect. In contrast, the analgesic or antibiotic treatment the first dose should be reduced for a quick effectiveness. Only subsequent doses will be reduced.
* The very latest drugs, which have rarely been specific studies in the elderly should be avoided.
* When it is followed by several specialists, it is preferable to have a GP who can link and check the consistency of different requirements.
* It is very important to drink to avoid dehydration, which would add toxic effects.
* When prescribing, it is best to ask the doctor what to do if you miss a drug.
* Use a pillbox reduces the risk of errors.
* Any unusual event, especially confusion, fatigue, should lead to suspicion of a toxic effect and to consult his doctor. It is the same in case of diarrhea, vomiting or fever, which may disrupt e treatment.
* Finally, seniors who are already several treatments must avoid the most self-medication.
Tags: Bodies Underperforming, side effects, the risk of accidents, the risk of medication errors
