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Gerontological Nursing 2 credit undergraduate course Page 6 of 20

Week 3: Polypharmacy

Learning objectives: Identify the demographics of medication usage in older adults Define polypharmacy and describe related provider/client characteristics Identify normal anatomical, physiological, & functional changes of aging, as related to drug absorption, distribution, and clearance Describe adverse reactions to medications commonly occurring in older adults Identify iatrogenic problems associated with multi-geriatric syndromes and their mediation regimens Discuss strategies for preventing polypharmacy and enhancing medication compliance/adherence Develop an understanding of the complex cost issues related to medications for older adults Discuss effects of tricyclic antidepressant drugs in older adults

Readings: Required:

Gerontologic Nursing, 2nd edition Chapter 21: Pharmacologic Management

Gray, S.L., Sager, M., Lestico, M.R., & Jalaluddin, M. (1998). Adverse drug events in hospitalized elderly, The Journals of Gerontology, 53A(1), M59-M63.

Owens, N.J., Silliman, R.A., & Fretwell., M.D. (1989). The relationship between comprehensive functional assessment and optimal pharmacotherapy in the older patient, DICP, The Annals of Pharmacotherapy, 23, 847-853.

Optional:

Flaherty, J.H., Perry, H.M., Lynchard, G.S., & Morley, J.E. (2000). Polypharmacy and hospitalization among older home care patients. The Journals of Gerontology, 55A(10), M554-M559.

Hanlon, J.T., Shimp, L.A., & Semla, T.P. (2000). Recent advances in geriatrics: drug-related problems in the elderly. The Annals of Pharmacotherapy, 24, 360- 365. (see Tables)

Lecture/discussion:

  • 1.

    Medication usage in older adults

    • a.

      Demographic trends

      • i.

        #s of prescriptions, economic implications

    • b.

      Definition of polypharmacy

    • c.

      Factors that lead to polypharmacy

      • i.

        Patient characteristics

      • ii.

        Prescriber characteristics

  • 2.

    Brief overview of normal age-related physiologic changes and effects on drug absorption, distribution, clearance (covered in greater detail in NURS 309)

  • 3.

    Adverse reactions to medications commonly occurring in older adults

    • a.

      Causes

    • b.

      Examples

Permission is hereby granted to reproduce, post, download, and/or distribute, this material for not-for-profit educational purposes only, provided that Northwest Coalition for Geriatric Nursing Education is cited as the source. This material may be downloaded and/or distributed in electronic format, including PDF format. Available on the internet at www.geronursinged.org E-mail notification of usage to: soncgne@ohsu.edu

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