Geriatric Medicine

Answer 1 Adverse drug reactions in older adults appear unrelated to the number of medications taken. Geriatric patients consume a disproportionate number of medications, compared with the rest of the US population. Polypharmacy, the use of multiple prescribed and over-the-counter medications and nutritional supplements, is a cause of adverse drug reactions. The chronic use of 2 medications simultaneously is associated with a 15% risk for adverse drug reaction, but the use of 5 drugs results in a risk of over 50%. Rather than age, the number of medications taken appears related to adverse effects in older adults. Institutionalized geriatric residents take a large number of medications, with cardiovascular, analgesic, and central nervous system agents being the most frequently prescribed. SUGGESTED READINGS 1. Dharmarajan TS, Tota R. Appropriate prescribing of medications in older adults. Fam Pract Recert 2000;22:29-38. 2. Leipzig RM. Pharmacology and appropriate prescribing. In: Cobbs EL, Duthie EH, Murphy JB, editors. Geriatrics review syllabus, 4th ed. Dubuque (IA): Kendall/Hunt Publishing Co; 1999:30-5. 3. Schwartz JB. Clinical pharmacology. In: Hazzard WR, Blass JP, Ettinger WH, et al, editors. Principles of geriatric medicine and gerontology. 4th ed. New York: McGraw-Hill, Health Professions Division; 1999:303-31. Click here to return to the questions

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