Updating the beers criteria for

Some older patients have swallowing problems which may mean that tablets are not the best form in which to prescribe their treatments.

Tablets that remain in the mouth or oesophagus for long periods may cause ulceration.

A list of agents to be avoided or used with extreme caution in the older patient can be accessed via Reference 5.

A Swedish study showed a significant drop in such events when geriatric patients due to be discharged from hospital were handed a formal Medication Report.The cookies contain no personally identifiable information and have no effect once you leave the Medscape site.Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. You may find one of our health articles more useful.In order to use Medscape, your browser must be set to accept cookies delivered by the Medscape site.Medscape uses cookies to customize the site based on the information we collect at registration.Renally excreted drugs with a narrow therapeutic index, such as digoxin, should be used cautiously and at low-dose levels; drug levels should be checked if there is a reason to suspect toxicity.Other pharmacokinetic considerations in older patients include: In the very elderly, the daily maintenance dose should be 125 micrograms.There are a number of agents which expert consensus and repeated trials have shown to be associated with a much higher risk of adverse events in the older recipient.Despite this, community surveys of the prescription of such agents show a relatively high rate of their prescription to older patients of around 16-18% per patient year for ambulatory, community-based older patients.Find out what your patient understands about the various medications that they are taking, how they should be taken and how they affect them, before adding in another agent.The most important alteration in drug metabolism in the elderly is a reduction in renal clearance.

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