GeriQBank · Topic
Principles of drug therapy, polypharmacy and deprescribing.
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Definition of the problem. Drug therapy in old age is the art of matching a drug to a body whose handling of and response to drugs has changed, in a patient who usually has several diseases and takes several drugs at once. Scale of the…
Definition. Rational prescribing means giving the right drug, in the right dose, by the right route, for the right duration, to the right patient, at the lowest cost, with an explicit indication and a plan for review. Two errors, not…
No single agreed definition. Polypharmacy has been defined in about 24 different ways, which has made it hard to measure and to compare studies (Pathy, Ch. 10). Numerical definition. The most widely used cut-off is the concurrent use of…
Definition. A drug holiday is a planned, temporary, supervised interruption of a drug in a patient who is expected to resume it, undertaken for a defined purpose and with a defined monitoring plan. Distinguish it from three other…
Textbook coverage: Pathy's (Ch. 38, Respiratory infections) covers tuberculosis in old age — higher infection rates in those over 65, nursing-home outbreaks, atypical presentation with less fever, sweating and haemoptysis, more…
Textbook coverage: Malaria is not covered as a disease entity in Pathy's Principles and Practice of Geriatric Medicine (6th ed.) or Essentials of Clinical Geriatrics (7th ed.); antimalarials appear only incidentally — chloroquine and…
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The three forms of suboptimal prescribing. Overuse (drugs without a valid indication), misuse (potentially inappropriate medications, wrong dose or inadequate monitoring) and underuse (omission of indicated, beneficial drugs).…