Caution urged when prescribing for elderly
Medication requirements may change as a patient's metabolism slows and
side effects persist longer.
By Susan J. Landers, AMNews staff.
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Wa****ngton -- A new study by Duke University researchers seems like
d=E9j=E0 vu all over again in its finding that large numbers of elderly
Americans are receiving prescriptions for medications that are
believed to be potentially dangerous for them.
The study found that over the course of a year, one in five of the
more than three-quarters of a million elderly patients studied filled
a prescription for at least one drug determined to be inappropriate by
a panel of geriatricians and others.
ADVERTISEMENT Two drugs, amitriptyline and doxepin, accounted for 23%
of those prescriptions, said the researchers.
Some drugs impact elderly people differently, largely because of
slower metabolism. "Drugs tend to stick around much longer in an older
person's body than they do in a younger person's," said the study's
lead author Lesley Curtis, PhD, assistant research professor at the
Duke Center for Clinical and Genetic Economics.
Side effects such as dizziness and sleepiness may linger from evening
into the next day for older people, thus increasing their risk for
falls and other accidents. The potential problems are often
exacerbated by multiple medications taken for several chronic
conditions.
Dr. Curtis and colleagues used a large outpatient prescription claims
database of a national pharmaceutical benefit manager to see which of
the 765,423 subjects 65 or older had filled prescriptions for
medications that met criteria first developed in 1991 by Mark H.
Beers, MD, and associates for determining which drugs older people
should avoid
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