[Basics of gerontopharmaceutic therapy and the therapy of agitation in old age].
The biggest problem of gerontopharmaceutic therapy is polypharmacy, because it potentiates side effects and malcompliance. Best practice today includes instruction of long time patients in medication self management, which includes regular use of detailed taken medication lists. In gerontopharmaceutic therapy the following substances should be avoided: anticholinergics, dopamin receptor stimulants, long acting oral antidiabetics, benzodiazepine (other then for substitution in low dose dependency, in anaesthesia or in palliative situations) and neuroleptics (other then for psychotic symptoms). In unspecific agitation with or without dementia the measure of first choice is adaption of the milieu, which may be supported by the prescription of a sedative non tricyclic antidepressive medication.
Wettstein
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Stadtärztlicher Dienst, Zürich. Wettstein.Albert@zuerich.ch
D000367:Age Factors; D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions; D005853:Geriatrics; D006707:Homes for the Aged / Q000592:standards*; D006801:Humans; D009735:Nursing Homes / Q000592:standards*; D010166:Palliative Care; D010349:Patient Compliance; D019338:Polypharmacy; D011595:Psychomotor Agitation / Q000188:drug therapy*; D012648:Self Care; D012893:Sleep Wake Disorders / Q000188:drug therapy; D013557:Switzerland