Understanding the Use of Drugs: Benefits, Risks, and Guidelines

The use of drugs in the elderly must take into account the differential characteristics that these individuals have, both anatomical, metabolic, functional and even social and environmental.

As always, in medicine, it must be taken into account that the benefit of an action (in this case the administration of a drug) must be greater than the possible harm that may occur. In the words of the ancient Romans "above all, do no harm" or primum non nocere.

Individuals of geriatric age have less capacity to adapt to changes and less physiological reserve, factors that lead to an increase in their frailty. Given this, the doctor should be more prudent, if possible, when prescribing any medication and especially the following points should be taken into account:

• Start the pharmaceutical prescription at low doses and, after monitoring the desired and unwanted effects, assess the gradual increase in doses.
• Recommend drugs with recognized therapeutic effect and avoid their administration at the request of the patient.
• Avoid molecules considered inappropriate for use in the elderly.
• Review therapeutic regimens on a regular basis, to withdraw drugs that are no longer useful or that have already served their purpose.
• Monitor as necessary the effects of drugs, as well as possible adverse reactions.
• Share the information among all health professionals who consult the patient, in order to avoid adverse reactions due to cross or repeated prescription of drugs.
• Explain to the patient and their caregivers the reason for the prescription, its importance, what you want to achieve with its administration and what adverse effects can be expected. Consensus where possible, achieve greater involvement of patients and caregivers and thus improve health education.
• Construct administration guidelines as simple as possible, enhance the oral route if possible and associate the doses with daily activities, such as getting up in the morning or before a midday meal. It is convenient to give the guidelines in writing in a clear and intelligible way, taking into account possible sensory deficits.
• Ask about self-medication, taking treatments without a prescription and even about traditional, herbal or alternative remedies. These treatments have the same problems of interactions and adverse reactions as the regular medicine drugs.