Side effects of drugs.
Adverse drug reactions are very common in the elderly but most are predictable and preventable!
Adverse drug reactions are one of the commonest reasons for hospital admission of older people.
Older people with drug side effects tend to present differently with confusion, falls, immobility and incontinence, as compared to younger patients.
A big drop in standing blood pressure-postural hypotension causing dizziness, falls and feints is also a very common drug side effect of blood pressure pills, heart pills, prostate pills and Parkinson’s medications.
The therapeutic window of drug benefit versus toxic drug side effects narrows as we get older, and is predictable as the drug doses increase.
Protocol driven medicine based on flawed published studies which never include the frail elderly patients that I see, and fail to publish side effects of treatments such as low standing blood pressures and falls contribute to more drug side effects and poorer health outcomes.
The older body handles drugs differently to a younger person.
There is a decline in body size.
There is a decline in total body water so that drug concentrations are higher.
There is a decline in lean body muscle mass, so that there is less muscle to absorb excess drugs.
There is a decline in liver mass, so the liver is less able to metabolise the drugs, along with a decrease in liver blood flow to extract drugs from the system.
There is a decline in renal function, reducing the ability of the body to excrete the drugs.
For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.