Drug Usage in Surgical Patients: Preventing Medication-Related Problems

  • Richard A. Marottoli
  • Sean M. Jeffery
  • Roshini C. Pinto-Powell
Chapter

Abstract

On January 1, 2011, the first of the Baby Boomers will turn 65 years old. And so will begin the largest increase in the number of older adults ever seen. To put this in perspective, in the entire history of mankind, two-thirds of all people who have ever lived to the age of 65 are alive today [1]. Advances in pharmacotherapy are partially responsible for this unprecedented increase in longevity and will play a central role in reducing morbidity and mortality in this aging cohort. However, when it comes to older adults, medications are often improperly dosed, overprescribed, and poorly monitored for signs of toxicity. Furthermore, changes in pharmacokinetics associated with aging leave little room for error. Surgeons operating on elderly patients should preoperatively identify potential medication-related problems (MRPs) that can result in postoperative complications. This chapter reviews some of the factors that contribute to MRPs in the elderly, general approaches to prescribing, signs and symptoms to monitor, and highlights of certain drug categories that are commonly used or have substantial potential to cause side effects in older adults.

Keywords

Fentanyl Levodopa Vancomycin Haloperidol Simvastatin 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Richard A. Marottoli
    • 1
  • Sean M. Jeffery
  • Roshini C. Pinto-Powell
  1. 1.Department of Internal Medicine (Geriatrics)Yale University School of Medicine, VA Connecticut Healthcare SystemNew HavenUSA

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