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Polypharmacy among the elderly
Polypharmacy case study geriatric
Polypharmacy among the elderly
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The geriatric population is rapidly growing as individuals continue to benefit from medical advances and pharmaceutical treatments. A large number of this population will need to take some form of medication to maintain a functional lifestyle. Multiple medications can affect the elderly population differently than younger generations. This paper will discuss how polypharmacy impacts geriatrics and the will focus specifically on analgesics and antihistamines. It will also examine demographic factors, changes within the aging body, prescription and nonprescriptive medications, and the role of the nurse practitioner when caring for these patients. Polypharmacy and the Geriatric Population According to the World Health Organization (WHO), the aging population will continue to grow due to the falling fertility rates and the increases in life expectancy. However, this population has distinctive, demographic factors that may influence their adherence to medication necessities. Dynamics that affect medication regimen in the elderly can be related to “memory and cognition (forgetting to take medication), dexterity (unable to open medication or break pills in half), low literacy, concern about side effects …show more content…
“Reduced lean muscle mass by about 20 percent and decreased total body water by 10 to 15 percent, implicate changes in the absorption of many drugs”(Woo & Wynne, 2011, p. 1424).This can result in higher serum concentrations of medications at normal dosages. Body fat stores increases and lipid-soluble drugs have a “higher tendency to accumulate in adipose tissue, resulting in lower serum concentrations and prolonged duration of action due to an increased half-life”(Woo & Wynne, 2011, p. 1424). Decrease albumin levels can lead to higher levels of unbound medication available for metabolism and tissue perfusion, allowing freer circulating
...teract. Many of the medications are very powerful in and of themselves. This article also presents additional approaches to medicating the elderly, including focus on reduction of number of medications prescribed. Both articles present the importance of considering the normal physiological changes within geriatric patients.
Treating depressive and bipolar disorders with antidepressants remains a popular option in clinical practice. Most clinicians choose the drug or class of drugs, usually selective serotonin reuptake inhibitors, SSRI's, that is most effective and best tolerated with fewer severe side effects. These drugs are beneficial because they specifically target serotonin-based areas of the brain without affecting other neurotransmitter systems. SSRI's largely replaced tricyclic antidepressants which work by blocking the absorption (reuptake) of the neurotransmitters serotonin and norepinephrine, thereby increasing the levels of these two neurotransmitters in the brain. Tricyclic antidepressants present severe side effects and thus are usually only used when other treatments have failed. If SSRI's or tricyclics are not effective Monoamine oxidase inhibitors may be prescribed. MAOI's, enhance tyramine to increase norepinephrine and serotonin. While taking MAOI's you must abstain from foods and alcohol that contain tyramine such as, yogurt, aged cheese, and substances such as cold medications. This is because a potential toxic reaction could occur. Additionally, other antidepressants may be utilized such as Wellbutrin (bupropion) an NDRI-
When doctors prescribe medication for their patients, a local retail pharmacy is most likely to be utilized to fill the order. However, there is a growing population of older Americans that are no longer able to live independently and must reside in nursing homes or assisted living facilities. In order for this vulnerable population to receive their medications, a different kind of pharmacy is needed, these are known as LTC, long term care pharmacies. Within these specialized pharmacies there are highly trained employees called CPhTs, certified pharmacy technicians who are overseen by state licensed RPHs, otherwise known as pharmacists.
Almost everybody on Long Island, and probably all around the world, has been prescribed a drug by a doctor before— whether it was to knock out a nasty virus, or relieve pain post injury or surgery. However, what many people don’t realize is that these drugs can have highly addictive qualities, and more and more people are becoming hooked, specifically teenagers. But when does harmlessly taking a prescription drug to alleviate pain take the turn into the downward spiral of abuse? The answer to that question would be when the user begins taking the drug for the “high” or good feelings brought along with it—certainly not what it was prescribed for (1). The amount of teens that abuse prescription medications has been rapidly increasing in recent
This assignment will discuss the professional, legal and ethical issues related to the self-use of medication by nurses. It will also explore the importance of reporting this misconduct by both professionals in the scenario and how they might do so. The self-use of medication by nurses is not allowed or justifiable according to the guidance provided to nurses by An Bord Altranais (ABA 2007). It will also be evident throughout this assignment the need for Jack to report Linda’s self-use of the medication or urge Linda to do so regardless of the consequences it may present to both him and Linda as according to Nurses and Midwifery Board of Ireland (NMBI 2013), nurses can now be held responsible for not taking action. This is because delivering the greatest level of care to a patient is an essential role of a nurse and the main focus of the nurse’s work should be on caring for that patient (ABA 2010). There is also an ethical duty upon both nurses to report the misconduct according to the four ethical principles; Beneficence, non-maleficence, justice and autonomy (Edwards 2009).
There are profound effects of ageism that can be harmful to a patient’s overall health. Ageism can cause physicians to consistently treat older patients unequally compared to younger adults. Unequal treatment can be divided into the under-treatment of symptoms and the over-treatment of symptoms. The imbalance in how a physician would treat a geriatric patient is ageist because the older adult is not getting fair treatment in every case. Under-treatment and over-treatment are different; however, they are both equally as harmful to a patients health.
Acid is produced naturally in your stomach to help you digest food and to kill bacteria. This acid irritates the stomach lining so our body produces a natural mucus barrier which protects it. Sometimes this barrier may be damaged thus allowing the acid to damage the stomach causing inflammation, ulcers and other conditions. Other times, there may be a problem with the muscular band at the top of the stomach that keeps the stomach tightly closed and this allows the acid to escape and irritate the oesophagus. This is called 'acid reflux' and can cause heartburn and/or oesophagitis. Proton pump inhibitors such as omeprazole stop cells in the lining of the stomach from producing too much acid. This can help prevent ulcers from forming or assist the healing process. By decreasing the amount of acid, they can also help to reduce acid reflux related symptoms such as heartburn.
The rise in cost of prescription drugs affects all sectors of the health care industry, including private insurers, public programs, and patients. Spending on prescription drugs continues to be an important health care concern, particularly in light of rising pharmaceutical costs and the aging population. Prescription drugs have grown to become an essential component of health care. For millions of Americans, prescription drugs are necessary to their health and ability to function in society. While prescriptions are a relatively small portion of overall health spending, they are a main reason for certain health spending trends, growing almost twice as fast all other health services in recent years. Prescription costs can be the costliest expense in your budget, especially if you are on a fixed income. The wealthy can easily afford their medications, but for an increasing population such as the elderly, choosing among purchasing medication, paying bills, or buying food is a real concern.
Prescription drugs do not always cause addiction, but a specific group of prescription narcotics can increase dependency on the medication and cause a severe addiction. For many people that become addicted to prescribed medicines, it changes their life forever. Prescription drugs are equally as dangerous as street drugs, if not more so. High powered pain relievers are safe if taken properly, but some people pop multiples a day which can cause coma and even death.
Prescription drug abuse has become a major epidemic across the globe, shattering and affecting many lives of young teenagers. Many people think that prescription drugs are safer and less addictive than “street drugs.” After all, these are drugs that moms, dads, and even kids brothers and sisters use. The dangers are not easily seen, but the future of our youth will soon be in severe danger if the problem is not addressed,it will continue to get worse if action is not taken soon. Prescription drugs are only supposed to be consumed by patients who have been examined and have a medical report by a professional, more and more teens are turning to the family’s medicine cabinet to “get high” but what they are actually doing is severely harming themselves, kids today are turning away from the street drugs and abusing the “prescribed” drugs that are that are at their very own home.
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Patients who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. There is a great need for nursing interventions in conducting a patient medication review also known as “brown bag”. As nurses obtain history data from patients at a provider visit, the nurse should ask “what medications are you taking?” and the answer needs to include over-the-counter medications as well. If the response does not include any medications other than prescribed meds, it is incumbent upon the nursing professionals to question the patient further to ensure that no over-the-counter medications or supplements are being consumed. This is also an opportunity for the nurse to question about any adverse reactions the patient may be experiencing resulting from medications. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients continuing to take medications that have been discontinued by the physician. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Waking up in the morning seems to be a task that daunts us all at some point in our lives. Fighting the grogginess that continues to descend upon someone’s waking mind. What if instead of eventually going away, that feeling stayed was there every single waking minute? People who have depression often feel this way, except instead of fighting grogginess they are fighting themselves. According to Merriam Webster antidepressants are defined as “used or tending to relieve or prevent depression” (“Definition of Antidepressants” 2018). Antidepressants are one of the most common remedies for depression. If they work effectively or not is another question. Some argue that people should be allowed to take antidepressants because they boost concentration,
becoming a major problem, and risk factor in schools, and is being abused all over the United States.
Life expectancy has grown over the last 100 years. This leads to a variety of health issues and problems that affect these elder generations quality of life. According to the United States CDC, one in three American adults suffers from hypertension. With so many Americans having high blood pressure it is no surprise that hypertension is one of the most dangerous conditions, leading to death, in the elderly. Doctors often skip directly to subscription, medications to help control elevated blood pressures, but other problems can arise from these medications, like dementia. The earlier the hypertension is diagnosed, the faster doctors can help create a treatment plan individually tailored to help the sufferer.
Being a pharmacist means entering into a diverse yet extremely rewarding field of work. Pharmacists are heavily involved in the preparation and dispensing of medicinal drugs. However, some pharmacists are involved in the actual research and development for the pharmaceutical manufacturers. Pharmacists fall into the Health Science career cluster. As of right now, the demand for pharmacists is going up at a steady rate due to the rapid expansion of the healthcare and pharmaceutical industries (Job Outlook for Pharmacists). Pharmacists are generally stationed in one location for the duration of their work. Unless of course a pharmacist is leaving to study more on efficient ways to work, info on new drugs, etc.. Pharmacists work year round doing virtually the same thing they started doing. Give or take a few new or old drugs being introduced there is not significant amounts of change that happens in this occupation regarding time such as peak times. Although, it could be argued that during some seasons there is more of a demand for prescription drugs to be given out because it might be a “sick season”. Therefore, this would cause a “peak” period. Most pharmacists generally work 40 hours a week. As with all professions though there are pharmacists, around 12%, that work more than 50 hours per week (Pharmacists - What They Do). Being a pharmacist requires a fairly decent amount of well tuned motor skills. This is simply because a pharmacist with shaky hands can overprescribe someone due to maybe giving more than the intended amount. The starting salary for a Pharmacist is between $81,000-$113,000 a year (Job Outlook for Pharmacists). Pharmacists are considered to have one of the most well paid health care jobs in the industry. They ca...