Chapter 15

Prescribing Medications for Older Adults: Dealing with Obesity, Misuse, Polypharmacy and Adverse Drug Events!

T.S. Dharmarajan and S. Davuluri

Abstract

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.

Total Pages: 281-305 (25)

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