- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Chapter 14 A life course approach for understanding later life sustainability
- Chapter 15 Ageing, multimorbidity, and daily functioning
- Chapter 16 Comprehensive geriatric assessment: evidence
- Chapter 17 Comprehensive geriatric assessment
- Chapter 18 Engaging older patients in their treatment and care
- Chapter 19 Models of healthcare for older people
- Chapter 20 History taking and physical examination
- Chapter 21 Communication
- Chapter 22 Interprofessional team building and case management
- Chapter 23 Age-friendly environments and their role in supporting Healthy Ageing
- Chapter 24 Principles of medication management
- Chapter 25 Optimizing pharmacotherapy for older patients
- Chapter 26 Limitations in the evidence for safe and effective medications for older people
- Chapter 27 General principles of recovery and rehabilitation
- Chapter 28 The approach of dying and death, and the mourning process of the survivors
- Chapter 29 Legal and ethical issues in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing
(p. 177) Principles of medication management
- Chapter:
- (p. 177) Principles of medication management
- Author(s):
David G. Le Couteur
, Andrew J. McLachlan
, and Sarah N. Hilmer
- DOI:
- 10.1093/med/9780198701590.003.0024
Older people use numerous medications, yet the evidence for effectiveness in old age is often limited while the evidence for medication-related harm is substantial. Issues common in older people such as multimorbidity, polypharmacy, frailty, dementia, and terminal illnesses influence the decision to prescribe or deprescribe. Age-related changes in drug disposition, coupled with concerns about adverse drug reactions often necessitate lower maintenance doses. Medical ethics and the principles of pharmacokinetics and pharmacodynamics provide overarching frameworks to tailor evidence-based medicine and single disease guidelines to the individual needs and goals of older and frail people. Close monitoring combined with the assumption that any symptom can be medication-related are key clinical skills required for the ongoing optimization of medication use in older people.
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- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Chapter 14 A life course approach for understanding later life sustainability
- Chapter 15 Ageing, multimorbidity, and daily functioning
- Chapter 16 Comprehensive geriatric assessment: evidence
- Chapter 17 Comprehensive geriatric assessment
- Chapter 18 Engaging older patients in their treatment and care
- Chapter 19 Models of healthcare for older people
- Chapter 20 History taking and physical examination
- Chapter 21 Communication
- Chapter 22 Interprofessional team building and case management
- Chapter 23 Age-friendly environments and their role in supporting Healthy Ageing
- Chapter 24 Principles of medication management
- Chapter 25 Optimizing pharmacotherapy for older patients
- Chapter 26 Limitations in the evidence for safe and effective medications for older people
- Chapter 27 General principles of recovery and rehabilitation
- Chapter 28 The approach of dying and death, and the mourning process of the survivors
- Chapter 29 Legal and ethical issues in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing