Elderly

More than 30% of all prescriptions and more than 50 percent of all over-the-counter medications in the United States are consumed by patients who are over 60 years of age. It is this group of patients who are three times more likely to be admitted to a healthcare facility for an adverse reaction to medication.

Fifty-one percent die from these reactions; 70 to 80 percent of the adverse reactions are dose related.

There are several important reasons for such a high occurrence of adverse response to medication. These include:

• Polypharmacy (multiple medications are prescribed without discontinuing current medication, causing an interaction between drugs);

• Medication can impair the mental and physical capacity leading to accidental injury;

• Age can increase the sensitivity to drugs and drug-induced disease;

• Absorption of medication is altered due to an increase in gastric pH;

• Distribution of the medication is affected because of a decrease in lean body mass, increased fat stores, a decrease in total body water, decreased serum albumin, and a decrease in blood flow and cardiac output;

• Metabolism changes as enzymatic activity decreases with age, and liver function;

• Excretion is impaired due to decreased kidney function.

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