We hope you have added to your knowledge skills and attitudes about Medication Management in the Older ED Patient. It is important to understand the physiologic changes that occur in the aging body – especially in the hepatic, renal, cardiac, and neurologic systems—and how those changes affect prescribing. Keep in mind the high-risk classes of medications, both the low-benefit (NSAIDs, benzodiazepines, anti-cholinergics) and the high-benefit ones (warfarin, opioids, and hypoglycemics), and develop your own strategies for avoiding or using them safely. Have strategies for developing a complete medication review (review the “pill bag,” go over the Medication Administration Record, call the pharmacy) and for communicating clearly any changes to the patient (written instructions, feedback to the primary care-giver).
Review the Learning Objectives before proceeding to the Knowledge Check.
At the end of this module you should be able to:
- Describe the physiologic changes associated with healthy aging that affect drug metabolism;
- Explain how physiologic changes affect prescribing in the older patient;
- Select appropriate drugs and dosages considering the patient’s acute and chronic diagnoses, other medications, and functional status,
- Recognize high-risk medication classes and how they can be safely used or avoided;
- Demonstrate an approach to polypharmacy including an awareness of drug-drug and drug-disease interactions;
- Demonstrate strategies for effective communication about medications.