Monane M, Monane S, Semla T
Department of Medical Affairs, Merck-Medco Managed Care, LLC, Montvale, New Jersey 07645, USA.
West J Med. 1997 Oct;167(4):233-7.
Pharmacotherapy represents one of the most important ways in which the practice of geriatric medicine differs from conventional medical care. The older patients is a major consumer of prescription and nonprescription medications, and proper use of these agents can lead to more cost-effective strategies in reaching optimal health. A key difference in distinguishing appropriate from inappropriate drug use is evident in the themes of polymedicine and polypharmacy. Polymedicine describes the use of medications for an older population for the treatment of multiple co-morbid conditions, while polypharmacy represents a less-than-desirable state with duplicative medications, drug-to-drug interactions, and inadequate attention to pharmacokinetic and pharmacodynamic principles. The purpose of this paper is to outline strategies toward optimal medication use as a key to successful aging. Specifically, we discuss themes of cost-effective prescribing, the role of medication compliance, overuse and underuse of medication, over-the-counter products, alcohol abuse, and preventive medicine. In addition, we discuss policy implications and responsibility for ensuring the high quality of pharmaceutical care. The reader should have a practical understanding of the pertinent issues in geriatric clinical pharmacology and its relationship to successful aging.
药物治疗是老年医学实践与传统医疗护理不同的最重要方式之一。老年患者是处方药和非处方药的主要消费者，正确使用这些药物可以带来更具成本效益的策略，以实现最佳健康状态。区分适当用药与不适当用药的一个关键差异在多药治疗和多药合用的主题中很明显。多药治疗描述的是老年人群使用药物治疗多种共病状况，而多药合用则代表一种不太理想的状态，存在重复用药、药物相互作用以及对药代动力学和药效学原理关注不足的问题。本文的目的是概述实现最佳药物使用的策略，这是成功老龄化的关键。具体而言，我们讨论了具有成本效益的处方主题、药物依从性的作用、药物的过度使用和使用不足、非处方药产品、酒精滥用以及预防医学。此外，我们还讨论了政策影响以及确保高质量药学护理的责任。读者应该对老年临床药理学中的相关问题及其与成功老龄化的关系有实际的了解。
