DRUG SAFETY AND EFFICACY IN GERIATRICS
DRUG SAFETY AND EFFICACY IN GERIATRICS
The use of medication in senior citizens or older adults should be with great caution. It is often a common thing to see elderly patients rushed into the emergency department as a result of wrong usage of drug or overdose.
It is our responsibility to ensure both the safety and the efficacy of the drugs being administered when it comes to the elderly.
DRUG EFFICACY
This is the ability of a drug to produce the desired effects. That is, if the drug is used for joint pains, the drug should be able to alleviate such pains with minimal or negligible side effects.
DRUG SAFETY
Some text has referred to this as pharmacovigilance. It is a process of assessing, detecting and preventing adverse effect of drugs. Therefore, the goal of every drug administered is to ensure proper drug efficacy and safety.
FACTORS THAT CONTRIBUTE TO HARMFUL EFFECTS OF DRUGS IN ELDERLY
1. Polypharmacy: This is the use of multiple medications to treat a patient. Most victims are senior citizens and people with multiple diseases. There are instances where this is inevitable, but the effects of drug to drug interactions should be considered before starting an elderly person on multiple medications.
2. Self Medication: This is another harmful practice by almost everybody, and not just the elderly. It is important that every medication administered is prescribed by a certified health professional to prevent unwanted effects of drugs on our senior citizens.
3. Overdose: Administration of drugs should not be done by the elderly themselves. If you leave them to administer drugs on themselves, they can either not use the drug or take overdose. To avoid this, it is good to have someone who is in charge of such an essential routine.
4. Continuous Usage: When the duration for which a drug was prescribed has been completed, it should be discontinued accordingly. Most senior citizens will keep the packs with the purpose of repurchasing such drugs. This can be very harmful, for example, there are some medications that will require proper monitoring of the functions of the kidney, liver and heart, so as to be able to determine if such drug is still safe in relation to the functions of the kidney, liver and heart. The harmful effects of using such drugs indiscriminately or continuously, when it should have been discontinued can only be better imagined.
SIMPLE WAYS TO PREVENT HAZARDS ASSOCIATED WITH MEDICATION USE IN ELDERLY
- Education: This aspect is often ignored by the home care nurse or whosoever is providing care to the elderly . Proper education about how the drug works, dosage,side effects, and desired effects are necessary information needed by the elderly which in turn helps to prevent hazards associated with medication. This can only be achieved when we communicate in the language they understand best, and avoid using ambiguous medical terms they can’t understand or comprehend.
- Labelling: As simple as it sounds, this is a very important step to eliminating hazards associated with medication use. Labelling includes the dosage and duration of each medication, it should be boldly written.
3. Drug Administration: This should be carried out by a care giver who lives with senior citizens, it could also be done by a home care nurse.
i. Checks: What are the things you should check before administering a drug?
-Name of the drug
-Dosage of the drug
-Time that drug is to be taken
-Duration ( how long should it be taken)
-Route or site of administration
-Contraindications
-Side effects
-Expiry dates
ii. Beers criteria: Ensure you follow beers criteria. This is a list of drugs that are potentially harmful in older adults, it would be great if you could read it up for proper guidance, especially if you are a health worker.
iii. Medical History: Knowing the health history of our senior citizens will enhance drug therapy in them. This will equally help the health professional who is going to prescribe. However, for you to be familiar with their health history you would have to be interested in them, go with them to the clinic and follow up visits. Ask questions about their health status. This is exactly what this blog is about, to help you develop passion for older persons.
DRUG SAFETY MARGIN
Let me end this post with this, the safety margin of drugs is usually calculated as ratio of the toxic dose to 1% of the populace to the dose that is effective in 99% of the populace. What do I mean by that jargon? Safety margin of drugs is simply the difference between the dose that will effectively give the desired outcome and the dose that can cause life threatening adverse effects. And it is always a thin line between the two. This is why drug safety and efficacy in elderly should be paramount to us all.
Author
My name is Adesuyi Adesina, the founder and CEO of Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.