Geriatric Pharmacology

Geriatric Pharmacology — Clinical Compendium

How it begins

El anciano es, a la vez, el principal consumidor de medicamentos y su principal víctima. El envejecimiento transforma simultáneamente la farmacocinética (qué hace el organismo con el fármaco) y la farmacodinamia (qué hace el fármaco en el organismo), mientras la pluripatología impone la polifarmacia . De esa convergencia nace la iatrogenia farmacológica: una causa mayor —y en gran medida prevenible— de reacciones…

What it covers

1. Why the elderly are pharmacologically different
2. · Epidemiology: the dimension of the problem
3. Pharmacokinetics: ADME in aging
4. · Absorption
5. · Distribution
6. · Hepatic metabolism
7. · Renal excretion
8. Kidney function and dose adjustment
9. · How to estimate glomerular filtration rate
10. · Drugs eliminated by kidneys that require monitoring
11. Pharmacodynamics and homeostasis
12. · Sensitivity changes in target organs
13. Polypharmacy
14. · Consequences of polypharmacy
15. · Factors that favor it
16. Adverse drug reactions (ADR)
17. · Risk factors for ADR in the elderly
18. · Drugs most frequently involved
19. Prescription cascade
20. · Classic examples
21. Drug interactions
22. · Drug-drug interactions
23. · Drug-disease interactions
24. · Drug-nutrient interactions and with "natural" products
25. Anti-cholinergic load
26. · Drugs with anticholinergic activity (often unsuspected)
27. Adequacy criteria: Beers · STOPP/START
28. High-risk pharmacological groups
29. Therapeutic adherence
30. · Adherence barriers in the elderly
31. Deprescription and prudent prescription
32. · Structured deprescription process
33. · Principles of prudent prescription