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Dissertation
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Benzodiazepines --- Benzodiazepines --- administration and dosage --- adverse effects
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Year: 2014 Publisher: Bruxelles: UCL,
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Belgium is one of the most benzodiazepines prescribing countries. However, they have many side effects such as dependence, tolerance and withdrawal risks. It’s recommended to use this drug for up to 4 weeks. But we note that many older people are chronic users with a peak of 50% in nursing homes. This figure is even more overwhelming that it’s a “risk group”. Indeed, we must be vigilant because the elderly are often polymedicated and show changes in their pharmacokinetic parameters. In addition, they have less physical strength and decreased alertness. All of this, combined with the use of benzodiazepines, increases the risk of drowsiness and decreases psychomotor performance. It results, for example, in falls and car accidents. Therefore, to treat insomnia in the elderly, the use of alternatives to benzodiazepines should be advised. Studies show that cognitive behavioral therapy has at least as much impact on sleep than hypnotics. “Z-drugs” have, for their part, a limited place in insomnia due to a similar risk-benefit ratio than benzodiazepine’s one. Melatonin, although highly prescribed, has been the subject of few studies. So, antihistamines should be used with caution in the elderly because of their anticholinergic actions and sedative antidepressants will rather be recommended for cases of insomnia associated with depression. Finally, although the results are not always unambiguous, the use of herbal medicine including valerian may be considered. The pharmacist’s role will be to deliver key massages about the use of benzodiazepines in the elderly and the provide an informed advice about alternatives.
Sleep Initiation and Maintenance Disorders --- Benzodiazepines --- Aged --- Aged, 80 and over --- Behavior Control
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ISBN: 1681080346 9781681080345 9781681080352 Year: 2014 Publisher: Sharjah, United Arab Emirates : Bentham Science Publishers,
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Demographic changes due to improved life expectancy and access to medical care has increased the number of people aged 65 years and beyond. This raises an important new challenge for healthcare professionals. Changes in organ functions, homeostatic mechanisms and receptor responsiveness impair drug distribution, metabolism and excretion, and reduce the effectiveness of medicines among geriatric patients. As a consequence, management of medical regimens is much more challenging in the elderly than in younger adult patients. Elderly patients are also more susceptible than other age groups to certain drug-drug interactions, drug-disease interactions and adverse drug reactions owing to the number of drugs administered. Polypharmacy and potentially inappropriate medication is a common finding in the elderly healthcare and it is considered a public health issue related to morbidity, mortality and health care resource use. Psychopharmacological Issues in Geriatrics can be regarded as a 'pharmacovigilance' manual for elderly patients as it presents recommendations for geriatric prescription with specific considerations. The eBook also provides a comprehensive review of specific classes of psychopharmacological agents used to treat geriatric patients, including antipsychotics, anxiolytics, hypnotics and mood stabilizers. The book is intended as a handbook for general medical and nursing practitioners.
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