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Drug Safety

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01.09.2020 | Leading Article

Drug Safety in Geriatric Patients: Current Status and Proposed Way Forward

verfasst von: Giovanni Furlan, Pia Caduff-Janosa, Laura Sottosanti, Emiliano Cappello, Giulia Valdiserra, Marco Tuccori

Erschienen in: Drug Safety | Ausgabe 9/2020

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Abstract

Elderly patients are the main users of drugs and they differ from younger patients. They are a heterogeneous population that cannot be defined only by age but should rather be stratified based on their frailty. The elderly have distinctive pharmacokinetic and pharmacodynamic characteristics, are frequently polymorbid, and are therefore treated with multiple drugs. They may experience adverse reactions that are difficult to recognize, since some of them present non-specific symptoms easily mistaken for geriatric conditions. Paradoxically, the elderly are underrepresented in clinical trials, especially the frail individuals whose pharmacological response and expected treatment outcome can be different from those of non-frail patients. This means that the benefit–risk balance of drugs used in frail elderly patients is frequently unknown. We present some proposals to overcome the barriers preventing the enrollment of frail elderly patients in clinical trials, and strategies for monitoring their therapy to minimize the risk of adverse reactions. Automated alerts for drug and drug–disease interactions could help appropriate prescribing but should flag only clinically relevant interactions. Pharmaceutical forms should be designed to allow easy dose adjustment and, together with packaging and labeling, should account for the physical and cognitive limitations of frail elderly patients. Aggregate pharmacovigilance reports should summarize the safety profile in the elderly, but rather than presenting the results by age they should focus on patients’ frailty, perhaps using the number of comorbidities as a proxy when information on frailty is not available.

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Titel: Drug Safety in Geriatric Patients: Current Status and Proposed Way Forward
verfasst von: Giovanni Furlan
Pia Caduff-Janosa
Laura Sottosanti
Emiliano Cappello
Giulia Valdiserra
Marco Tuccori
Publikationsdatum: 01.09.2020
Verlag: Springer International Publishing
Erschienen in: Drug Safety / Ausgabe 9/2020
Print ISSN: 0114-5916
Elektronische ISSN: 1179-1942
DOI: https://doi.org/10.1007/s40264-020-00949-w

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Drug Safety in Geriatric Patients: Current Status and Proposed Way Forward

Abstract

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

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