Poly-pharmacy in the Aged Adult: its prevention is possible?
Keywords:
Pharmacovigilance, Aged.Abstract
Introduction: ages adults generally present adverse reactions due to poly-pharmacy used for the association of several diseases existing at their age, alterations in the pharmacokinetics and pharmaco-dynamics of medicaments.Objective: to evaluate the state of poly-pharmacy, pharmaco-surveillance and geriatric posology to prevent the medication improper consumption.
Method: a prospective observational study was carried out of the state of pharmaco-surveillance in the aged adult admitted into the Pinar del Rio Dr. León Cuervo Rubio Clinical Surgical Provincial Teaching Hospital, in the period from January to July 2013.
Results: it has been determined that pharmaco-surveillance is not applied by the nursing staff in the 12.6%, while the 50% has learning needs, it was not possible to determine the onset of symptoms, and seriousness prevailed among antibiotics. The most reported adverse effects were in the patient over 65 years of age. The quality of the medical prescription, medication adherence and posology were reviewed, concluding that there were justified prescription and geriatric dosing in the majority of the patients.
Conclusions: it was detected a poor perception of adverse reactions to medications and a low record of notification reinforcing the need for establishing a continual program of pharmaco-surveillance and the generalization of strategies guaranteeing the security and rationality of the aged adults.
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1. Taché SV, Sönnichsen A, Ashcroft DM. Prevalence of adverse drug events in ambulatory care: a systematic review. Ann Pharmacother. 2011 Jul; 45(7-8): 977-89. Available from: http://aop.sagepub.com/content/45/7-8/977.
2. Díaz-Castro O, Datino T, López-Palop R, Martínez-Sellés M. Actualización en cardiología geriátrica. Rev Esp Cardiol [Internet]. 2011 [citado 9 Ene 2013]; 64(Supl 1): [aprox. 10 p.]. Disponible en: http://www.revespcardiol.org/es/actualizacion-cardiologia-geriatrica/articulo/90093465/
3. Montero B, Sánchez M, Sánchez C, Delgado E, Bermejo T, Cruz-Jentoft AJ. Inappropriate prescription in geriatric outpatients: A comparison of two instruments. J Nutr Health Aging [Internet]. 2008;12:585.
4. Liu CL, Peng LN, Chen YT, Lin MH, Liu LK, Chen LK. Potentially inappropriate prescribing (IP) for elderly medical inpatients in Taiwan: a hospital-based study. Arch Gerontol Geriatr [Internet]. 2012 [citado 9 Ene 2013]; 55(1): [aprox. 4 p.]. Available from: http://www.sciencedirect.com/science/article/pii/S0167494311002093
5. Oscanoa TJ. Diagnóstico de problemas relacionados con medicamentos en 9. Van Pottelbergh G, Van Heden L, Matheï C, Degryse J. Methods to evaluate renal function in elderly patients: a systematic literature review. Age Ageing [Internet]. 2010 [citado 9 Ene 2013]; 39(5): [aprox. 6 p.]. Available from: http://ageing.oxfordjournals.org/content/39/5/542.full
6. Inker LA, Schmid CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med[internet]. 2012; 367(1): 20-29. Available from: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1114248
7. Fuentes P, Webar J. Prescripción de fármacos en el adulto mayor. Medwave [Internet]. 2013 [citado 10 Oct 2013]; 13(4): [aprox. 2p.]. Disponible en: http://www.mednet.cl/link.cgi/Medwave/PuestaDia/Practica/5662
8. Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012 Apr; 60(4):616-31.
9. Sera LC, McPherson ML. Pharmacokinetics and pharmacodynamic changes associated with aging and implications for drug therapy. Clin Geriatr Med [Internet]. 2012 May [citado 12 Feb 2012]; 28(2): [aprox. 14 p.]. Available from: http://dialnet.unirioja.es/servlet/articulo?codigo=3926111
10. Abizanda P, Romero L, Luengo C, Sánchez P, Jordán J. Medicina Geriátrica. Una aproximación basada en problemas. Barcelona, España: Masson; 2012. p. 67-74.
11. Conejos MD, Sánchez M, Delgado E, Sevilla I, González Blázquez S, Montero B, et al. Potentially inappropriate drug prescription in older subjects across health care settings. European Geriatric Medicine 2010: 9-14.
12. Ryan C, O'Mahony D, Kennedy J, Weedle P, Byrne S. Potentially inappropriate prescribing in an Irish elderly population in primary care. Br J Clin Pharmacol [Internet]. 2009 [citado 22 Nov 2012]; 68(6): [aprox. 11 p.]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810806/
13. Delgado E, Alvarez A, Covadonga P, Muñoz M, Alfonso J, Bermejo T. Resultados de la integración de la atención farmacéutica en una Unidad de Agudos de Geriatría. Rev Esp Geriatr y Gerontol [Internet]. 2012 [citado 22 Nov 2012]; 47(2): 49-54. Disponible en: http://zl.elsevier.es/es/revista/revista-espanola-geriatria-gerontologia-124/resultados-integracion-atencion-farmaceutica-una-unidad-agudos-90122530-seccion-clinica-2012?bd=1
14. Pedrero P.M, Valdivia F, Hernandez M, Rodrigo G, Cordero M, Baca J,Cruz A. iGuía de práctica clínica. Prescripción farmacológica en el adulto mayor. Rev Med Inst Mex Seguro Soc. 2013 ;51(2):228-39. Disponible en: http://www.medigraphic.com/pdfs/imss/im-2013/im132u.pdf
15. The American Geriatrics Society. AGS Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (2012)[Internet]. [citado 12 Feb 2013]; 60(4): [aprox. 2p.]. Available from: http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/2012

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