Special Considerations

The following should be considered when prescribing drugs for elderly patients.

Drugs should be prescribed only if nonpharmaco-logical techniques are ineffective, such as for problems like sleeplessness and anxiety. When drugs are prescribed for these conditions, they should be given for a limited time and the patient closely monitored for adverse effects. Dosage should start at or below the lowest recommended levels.

Keep it simple. Prescribe drugs only if you have available extensive experience and prescribing information for that drug in elderly patients. Use the least number of drugs and doses per day.

Reevaluate the continued use of all medications the patient is receiving, including over-the-counter medications, on a regular basis.

Noncompliance is a significant problem, with almost 50% of elderly patients failing to take their medications as prescribed. Some of the reasons for noncompliance are inability to pay for the drug, side effects, mental impairment, and inability to understand complex instructions.

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