GERIATRIC PATIENTS >65

YEARS

DR REWATI RAMAN DEWANGAN

DR JINSY RAI
DEMONSTRATORS
DEPT OF PHARMACOLOGY
GMC AMBIKAPUR
GERIATRIC PATIENT HAVE MORE CHANCES
OF DRUG INTERACTIONS AND ADVERSE
REACTIONS DUE TO –

• Presence of multiple dis.

• Sluggishness body function.
• Reduced finances for health care.
• Nutritional problems.
• Loss of spouse.
• Poor patient compliance due to-
• Not able to understand proper dosage schedule.
• Confusion and forgetfulness and giddiness .
• Poor hearing and poor vision.
• Not able to take drug due to physical disability and tremors such as parkinson’s dis.
• Changes in pharmacokinetics and pharmacodynamics due to ageing.
PHARMACOKINETICS-

• Absorption- slow
• Distribution- the body weight is reduced thus water soluble drug dose to be reduced specially the
priming dose.
• Bio transformation- bio transformation is reduced due to decreased liver mass liver blood flow and
reduced ability to recover from liver injuries and thus inactivation of drug due to metabolism is also
reduced.
HEPATIC CLEARANCE REDUCED-
Alprazolam
Chlordiazepoxide
Diazepam
Flurazepam
Imipramine
Nortryptyline
Pethidine
Propranolol
Quinidine
Theophylline
• Excretion-
• Renal blood flow reduced.
• Decreased GFR
• Decreased creatinine clearance
• Renal toxicity causing drugs-
• LITHIUM
• DIGOXIN
• AMINOPHYLLINE
• ATENOLOL
PHARMACODYNAMICS-

• Response may be increased or decreased any they are more prone for adverse effects.
• RESPONSE IN DECREASED-
• Response of beta agonists as well as beta blockers are reduced due to reduced no of beta receptors.

• RESPONSE IN INCREAESD-
• Intolerance to digitalis
• Postural hypotension with drugs that reduces BP.
PRECAUTIONS REQUIRED WHILE
PRESCRIBING IN GERIATRIC PATIENT-
• Diagnosis should be correct.
• Donot prescribe a drug with major side effects.
• Minimum possible drugs to be prescribe.
• Dosage form to be most suitable.
• Packing to be taken care of.
• ADR.
• Drug history.
• FDCs
• Patient compliance.
• Discontinuation of drug or therapy.
• Thankyou.