Polypharmacy is an increasingly prevalent phenomenon among the aged population, especially those with multiple morbidities. The concurrent use of five or more drugs may be cumulatively beneficial; nevertheless, there is a substantial risk of developing adverse effects. Polypharmacy can lead to hepatotoxicity due to decreased hepatic mass in the elderly, which subsequently reduces the quantity of drugs that can be metabolized by the liver (Cantlay et al., 2017). Additionally, hepatic damage may arise due to the consumption of multiple drugs with a narrow therapeutic range, for example, warfarin and phenytoin. Another implication is the impairment of renal function, which is usually a consequence of the accumulation of drugs to toxic levels injurious to the kidney (Cantlay et al., 2017). In elderly populations, the occurrence of side effects, sensitivity, and adverse drug interactions is also elevated compared to that in younger people (Cantlay et al., 2017). This poses a greater risk to multiple organ damage and increases the aggressiveness of geriatric syndromes.
Practitioners should consider the pharmacodynamic and pharmacokinetic aspects of each drug to avoid adverse reactions. Old age is associated with several psychological and physiological changes that affect how senior populations adapt to drugs (Cantlay et al., 2017). It is therefore crucial that the physician relates each drug to the functionality and adaptability of the patient. Reducing the prescription of unnecessary polypharmacy drugs also reduces the risk of implications. To ensure safe administration, each patient should be assigned a physician and a pharmacist with background knowledge on the mechanism and interactions of prescribed drugs (Cantlay et al., 2017). More importantly, practitioners should double-check if the administered medications are antagonistic to each other. Physicians should educate senior patients on the use of Monitored Dose Systems (MDS) (Cantlay et al., 2017). MDS helps patients record and track their medication, increasing compliance and, by extension, positive health outcomes.
Reference
Cantlay, A., Glyn, T., & Barton, N. (2017). Polypharmacy in the elderly. InnovAiT: Education and Inspiration for General Practice, 9(2), 69–77. Web.