How to avoid adverse drug reactions in the elderly.

• Practice good holistic general medicine and focus on the whole patient

• Avoid multiple single organ Doctors (SODs) who each prescrible their own medications. Someone needs to take control to minimise adverse drug reactions and drug to drug interactions.

• Is the indication for the medication still present?

• Is the disease modifying treatment still helping symptoms?

• Is there an acceptable balance between efficacy and adverse effects?

• Is the dose appropriate for the older frailer patient?

• Are there any potential drug interactions?

• Are there better alternatives, either pharmacological or non-pharmacological?

• Weigh the patient.

• Calculate drug doses for age, weight, kidney function.

• Take into account other disease present such as chronic heart, lung, kidney, and liver disease which may mean reducing drug doses to avoid side effects.

• Educate the patient, family and Carers all about the drug doses, actions and possible side effects.

• Monitor for adverse drug reactions and drug to drug interactions.

• Side effects of blood pressure medication include postural dizziness, falls and feinting. The lying and standing blood pressure should always be measured in older people on high blood pressure pills.

• Use pill packs delivered by the local Chemist to improve drug compliance when on multiple pills.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.