'Healthy' prescribing for the elderly. How to minimize adverse drug effects and prevent 'dementia in a bottle'.

Despite constituting only 11% to 12% of the US population, the elderly use 31% of all prescription and over-the-counter drugs and, unfortunately, are most vulnerable to the adverse effects of drug therapy. Because of age-related physiologic changes and the likelihood of intercurrent disease, elderly patients need individualized prescribing. This requires the practitioner to be familiar with a few drugs in each class that are tolerated by and effective in elderly patients and to adhere to the principles of healthy prescribing, which have application in any setting. In conclusion, the words of Paracelsus (1493-1541) are worth recalling: "All substances are poisons; there is none which is not a poison. The right dose differentiates a poison from a remedy."