Drug therapy and the elderly patient.

An elderly woman recently walked into her doctor's office complaining of fainting spells. After examining her and finding nothing. obviously wrong, the physician casually asked if she was taking any medication. She returned the next day with two shopping bags stuffed with pills, some the same generic medication under two or even three different brand names. No wonder she was falling down, the doctor remarked later. The use and effects of drugs on the elderly has been of increasing interest to doctors, pharmacists and others involved in caring for elderly patients. At a recent conference on Drugs and the Elderly held in Toronto, Dr. Michael Gordon, senior physician at Toronto's Baycrest Centre for Geriatric Care, told his audience: If you aren't an obstetrician or a pediatrician, you're going to be a geriatrician. Because the incidence of illness increases as we age, many elderly patients may be on a number of medications simultaneously. One nursing home survey revealed that the average resident was taking six drugs a day, four of them by prescription and two more nonprescription medicines such as laxatives or analgesics. Twenty percent of all complications experienced by a group of elderly hospitalized patients in Boston were related to drugs. According to Susan Steinberg, a geriatric pharmacist at Toronto's Sunnybrook Medical Centre, doctors and patients themselves need to be more vigilant and aware of the duplicate actions and side effects of these drugs. Not only are elderly patients likely to be on more medication, says Dr.