title: Appropriate prescribing and important drug interactions in older adults.
abstract: Polypharmacy, specifically the overuse and misuse of medications, is associated with adverse health events, increased disability, hospitalizations, and mortality. Mechanisms through which polypharmacy may increase adverse health outcomes include decreased adherence, increased drug side effects, higher use of potentially inappropriate medications, and more frequent drug-drug interactions. This article reviews clinical problems associated with polypharmacy and presents a framework to optimize prescribing for older adults.
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, B-179, Aurora, CO 80045, USA. Electronic address: jeff.wallace@ucdenver.edu.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wallace
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Washington, 4245 Roosevelt way NE, #MC354760, Seattle, WA 98105, USA.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Paauw
mesh_terms: D000368:Aged / Q000502:physiology*; D000369:Aged, 80 and over / Q000502:physiology*; D002121:Calcium Channel Blockers / Q000009:adverse effects; D000077144:Clopidogrel; D004338:Drug Combinations; D004347:Drug Interactions; D006801:Humans; D057970:Inappropriate Prescribing; D007668:Kidney / Q000502:physiology; D008099:Liver / Q000378:metabolism; D008508:Medication Errors / Q000517:prevention & control; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control; D010349:Patient Compliance; D010599:Pharmacokinetics; D019338:Polypharmacy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D054328:Proton Pump Inhibitors / Q000009:adverse effects; D015363:Quinolones / Q000009:adverse effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects; D013411:Sulfadiazine / Q000009:adverse effects; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives; D014295:Trimethoprim / Q000009:adverse effects; D000096926:Benzenesulfonamides
chemical_list: D002121:Calcium Channel Blockers; D000077144:Clopidogrel; D004338:Drug Combinations; D054328:Proton Pump Inhibitors; D015363:Quinolones; D017367:Selective Serotonin Reuptake Inhibitors; D013411:Sulfadiazine; D013988:Ticlopidine; D014295:Trimethoprim; C024873:sulfadiazine, trimethoprim drug combination; D000096926:Benzenesulfonamides
keywords: Adherence; Adverse drug events; Drug interactions; Elderly; Polypharmacy; Potentially inappropriate medications