Principles of safe medication for the elderly
Release time:
2022-07-15
Due to physiological aging, hardening of arteries and blood vessels, reduction of liver and kidney organ function and reduction of liver blood flow and other factors, the absorption, distribution, metabolism, excretion time and clearance rate of drugs entering the body have decreased. Therefore, the elderly medication must be the correct choice of varieties, agents and routes of administration, as far as possible to reduce the adverse effects of drugs on the body.
Oral drugs are not only affected by the pH of digestive juice, but also by the state of gastrointestinal mechanical movement. The elderly gastrointestinal relaxation weakness, visceral prolapse, prone to gastrointestinal dysfunction, due to the rise of gastric juice pH and digestive enzyme secretion decreased, often affect the absorption of drugs. Oral drugs, almost 100% through the role of the liver to play a therapeutic effect. Due to the decrease in the number of liver cells in the elderly, the volume of liver lobules shrinks, the decrease of liver blood flow (40%-60% after the age of 60) and the decrease of microsomal drug oxidase P450 activity, etc., all affect the normal metabolism of drugs. 'Kidneys are the main route of excretion of drugs into the body. As the kidneys of the elderly become smaller, the number of functional glomeruli is reduced, the filtration volume and renal blood flow are reduced, and the concentration capacity of renal tubules is weakened, which affects the normal metabolism, excretion and clearance rate of drugs. Because of the poor tissue receptivity, the variation of tissue cell morphology, quantity and physiological function, and the reduction of tissue reserve capacity, the safety range between drug treatment dose and poisoning dose becomes smaller, which is easy to cause many adverse reactions, and even accumulate poisoning and endanger life.
Therefore, the elderly should pay attention to the following aspects of medication:
1. The correct use of drugs to avoid abuse. After diagnosis, symptomatic medication is the basis of rational drug use and the key to successful treatment. The elderly are unwell and should go to the hospital in time. If they abuse drugs only based on their knowledge of medicine, they will often cover up the truth of the disease and delay treatment opportunities. For example, the abuse of antibiotics will lead to dysbacteriosis and cause double infection. The disorderly administration of liver-protective drugs will backfire and increase the burden on the liver: people with high arteriosclerosis and blood viscosity will easily induce heart and stroke when taking ginseng; long-term administration of large doses of vitamin C will affect the absorption of vitamin E and inhibit the effect of vitamin B12, as well as induce kidney stones.
2 varieties should not be more, pay attention to side effects. Every year, 200000 people in our country lose their lives due to careless or improper use of drugs. The medication for the elderly should be as simple as possible, the variety should not be too much, and the dose should not be too large. During the medication, the side effects of the drug should be closely observed and treated in time.
Avoid or use fewer sleeping pills. Many elderly people often rely on sleeping pills. Long-term use of sleeping pills is prone to addiction and dependence. Sleeping pills will not only damage the liver function, but also may cause intelligence, memory disorders, accelerate the occurrence of arteriosclerosis, dementia.
4. Be wary of drug interactions. The elderly often suffer from a variety of diseases, in the hospital multi-department treatment, respectively take medicine, the formation of drugs for different diseases at the same time, and some drugs at the same time will lead to increased toxicity, antagonism or reduce efficacy. If digoxin is used in combination with dihydrochlorid plug, it will cause low potassium, low magnesium and digitalis poisoning; if antidiabetic drugs are used in combination with proprilol, it will mask the signs of hypoglycemia. Therefore, the elderly should take the initiative to tell the doctor what kind of medicine they are using for the doctor's reference when prescribing.
5. Avoid using nephrotoxic drugs. The elderly are prone to infection. When antibiotics must be used, gentamicin, kanamycin, buancana, tobramycin and other antibiotics sensitive to aminoglycoside nephrotoxicity should be avoided.
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