1: Lancet. 2007 Jul 14;370(9582):185-91.

The challenge of managing drug interactions in elderly people.

Mallet L, Spinewine A, Huang A.

Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada.

Drug therapy is essential when caring for elderly patients, but clearly it is a
double-edged sword. Elderly patients are at high risk of having drug
interactions, but the prevalence of these interactions is not well documented.
Several types of interactions exist: drug-drug, drug-disease, drug-food,
drug-alcohol, drug-herbal products, and drug-nutritional status. Factors such as 
age-related changes in pharmacokinetics and pharmacodynamics, frailty,
interindividual variability, reduced homoeostatic mechanisms, and psychosocial
issues need to be considered when drug interactions are assessed. Software can
help clinicians to detect drug interactions, but many programmes have not been
updated with the evolving knowledge of these interactions, and do not take into
consideration important factors needed to optimise drug treatment in elderly
patients. Any generated recommendations have to be tempered by a holistic,
geriatric, multiprofessional approach that is team-based. This second paper in a 
series of two on prescribing in elderly people proposes an approach to categorise
drug interactions, along with strategies to assist in their detection,
management, and prevention.

PMID: 17630042 [PubMed - indexed for MEDLINE]

Related Links

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