title: Monitoring in high level care.
abstract: BACKGROUND
  Prescribing for elderly patients in nursing homes in an area where appropriate patient monitoring is poorly managed.
  
  
  OBJECTIVE
  This article discusses the use of some commonly prescribed medications in elderly nursing home residents and how these medications should be monitored.
  
  
  CONCLUSIONS
  Many of the medications prescribed to nursing home residents may be appropriately prescribed initially, but their continuing prescription may be inappropriate in the setting of lack of effect and adverse reactions. It is important to appreciate that the response rate to many of the commonly prescribed medications such as tricyclic antidepressants, selective serotonin reuptake inhibitors, anticholinergics and antipsychotics, is limited in this population of patients and that they also have quite a significant potential for toxicity. Therefore, monitoring for the effects of therapy, as well as any potential adverse effects, is important to ensure the ongoing appropriateness of such prescriptions.
authors.affiliation: Department of Clinical Pharmacology, Royal Adelaide Hospital, Department of Clinical Pharmacology,  University of Adelaide, South Australia. sshakib@mail.rah.sa.gov.au
authors.forename: Sepehr
authors.initials: S
authors.lastname: Shakib
authors.forename: Alison
authors.initials: A
authors.lastname: George
mesh_terms: D000368:Aged; D001315:Australia; D019468:Disease Management; D016903:Drug Monitoring; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D064420:Drug-Related Side Effects and Adverse Reactions; D005194:Family Practice / Q000592:standards; D005853:Geriatrics / Q000592:standards; D006801:Humans; D009735:Nursing Homes / Q000458:organization & administration*