This is an automatically translated article.
Due to physical and psychological characteristics, the older the elderly, the more susceptible to many diseases. Even the use of drugs for the elderly also has potential risks of complications and complications, especially for neuroleptics, cardiovascular drugs, antidiabetic drugs....
1. Overview
Elderly people are counted as people aged 60 years and over, accounting for about 12% of the population but who need the most medical support (more than 50% compared to middle age), at risk Hospitalization for inpatient treatment tripled, outpatient visits accounted for 25-30% and up to 40% of people needed home care.
Especially, the rate of accidents and complications due to drug use in the elderly is also much higher than in other age groups.
According to statistics in the US, 1 in 6 elderly people taking medication, 1 in 6 experiences an adverse drug reaction (ADR) causing physical and mental disorders, even death.
Clinical manifestations in the elderly with ADR include: Anxiety, depression, confusion, cognitive disturbances, falls, constipation, urinary incontinence, extrapyramidal syndrome (EPS). , insomnia ....
2. Characteristics of drug use in the elderly
Elderly people may have a number of specific physical characteristics that interfere with effective drug use:
Co-morbidities: Requires use of different drugs to treat conditions his illness. This increases the risk of drug interactions, ADRs and other adverse reactions; Poor absorption of drugs: Due to the elderly's body may decline in organ function (kidney, liver, heart, digestive system...) easily leading to slow drug response or too strong response, drug accumulation and toxicity. Acute illness is more severe, recovery is slower; Limited self-reliance: Difficulty swallowing pills. Medicines can get stuck in the oral cavity causing sores; Weak immune function: Easy to get sick (fragile body), suffering from many diseases at the same time; Unstable health and psychological condition, may need the help of relatives and doctors.
Người cao tuổi thường mắc nhiều bệnh lý khác nhau nên cần thận trọng trong việc sử dụng thuốc phối hợp
Elderly people tend to self-medicate with over-the-counter drugs, or old drugs that have been prescribed in the past. previous visits, or taking other people's medications; Elderly people's memory declines, so it's easy to get confused in taking medicine, especially the dose and time of taking the drug. Should have relatives to support for the effective use of drugs for the elderly; Some people are too worried about their health and want to get better quickly, so they often self-medicate with more drugs than prescribed by the doctor. Or even if you don't get sick, you still use the drug to "precaution", arbitrarily increase the dose or prolong the time of taking the drug.... are psychological dependence on very dangerous drugs that can lead to overdose, causing poisoning. poison; On the contrary, some people are afraid that the drug will affect their health, so they voluntarily reduce the dose (instead of taking 3-4 times, only taking 1-2 times a day), some people stop taking the drug midway, affecting the treatment. definitively.
3. Principles of drug use for the elderly
Drug interactions to note:
Avoid using glucocorticoids for elderly people with diabetes (because glucocorticoids increase blood sugar); The nervous system of the elderly is easily affected by pain relievers with Opi, Parkinson's drugs, Benzodiazepines; Avoid taking antihistamines, antidepressants, antispasmodics with elderly people with benign prostatic hypertrophy or constipation (due to drugs causing urinary retention or worsening constipation); Avoid using beta-blockers in the elderly with asthma, diabetes, chronic obstructive pulmonary disease (due to masking symptoms of hypoglycemia in people taking antidiabetic drugs), peripheral vascular disease ; Do not use effervescent drugs with people with hypertension, heart failure (because effervescent drugs always contain sodium, which increases blood pressure); Do not use 2 types of non-steroidal anti-inflammatory drugs (NSAIDs) for the elderly because it can increase the risk of ulcers and gastrointestinal bleeding, kidney failure... Diuretics for high blood pressure can aggravate the condition. gout in people who have it. In general, the group of drugs that often cause complications in the elderly include: Digitalis (Digoxin), diuretic, antihypertensive, anticoagulant, antiarrhythmic, hypoglycemic, analgesic, antipyretic...
Tùy vào tình trạng sức khỏe của người cao tuổi mà bác sĩ đưa ra liệu trình dùng thuốc hợp lý
Principles of prescribing the elderly to use drugs:
Mastering the drug use history of the elderly (including prescription drugs, non-prescription drugs, functional foods...); Prescribing should be started at the lowest effective dose, and with appropriate prolongation of the dosing interval. Some drug doses need to be lower than the adult dose (eg, the anticoagulant warfarin); With drugs used for a long time, if possible, there should be a drug break to limit the phenomenon of drug accumulation; Prioritize liquid drugs, easy to swallow and less medicine; Use caution when prescribing new drugs to the elderly; Maintain monitoring and evaluation of the effectiveness and side effects of the drug (especially on the liver and kidneys). Stop taking the drug if the effect is not clear or there are signs of ADR; Avoid abuse of drugs, including those that are said to be “tonics” or functional foods; Pharmacological treatment of the elderly is primarily aimed at maintenance and recovery. The main goal of treatment is to cure the disease, limit complications and improve quality of life. To ensure health and safe use of drugs, the elderly should perform annual health check-ups. Currently, Vinmec is implementing a lot of general health checkup packages suitable for each age, gender and individual needs of customers with very favorable price policy, including:
Work general health checkup package permit- issue work permit Child Health Checkup Package Standard General Health Checkup Package Special General Health Checkup Package VIP General Health Checkup Package Diamond Health Checkup Package Advantages of the The medical examination package of Vinmec International General Hospital means that customers will be screened and screened by a system of modern equipment to help support the best diagnosis today such as PET/CT, MRI, etc. CT 640, the world's leading advanced ultrasound system, international standard laboratory system,... After a general examination, if any diseases are detected, customers can use the service. from other specialties at the hospital with outstanding quality of treatment.
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