Gerontological Nursing
Polypharmacy and Pharmacokinetics
Age-related changes in metabolism and excretion necessitate cautious medication management in the elderly.
Key Pharmacokinetic Changes
- Reduced renal clearance decreases drug excretion rates.
- Increased body fat prolongs the half-life of lipid-soluble drugs.
- Decreased liver mass and hepatic blood flow slows metabolism.
- Decreased serum albumin levels lead to higher free drug levels.
Nursing Strategies
- Utilize the Beers Criteria to screen for inappropriate meds.
- Implement 'start low and go slow' dosing philosophy.
- Perform medication reconciliation at every point of care.
- Assess for the 'prescribing cascade' (treating side effects with more meds).
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