Treatment characteristics in elderly.

The pharmacodynamics and pharmacokinetics of medications, their therapeutic and toxic effects are age dependant. In the treatment of old people polypharmacy is widely used. The most common results of polypharmacy are increased adverse drug reactions, drug-drug interactions. In this study the use of different medications at the Departments of General Medicine and Cardiology (Tbilisi Republic Hospital) was analyzed. The case histories (1995, 2000 and 2005) of 1708 patients were studied. It was found that in 2005 the number of 60 years and older patients has doubled comparably with 1995, but the number of 24-44 years old patients remained almost the same. The complication rate was higher in elderly as compared with younger patients. It was found that in treatment of elderly population hypotensive drugs, diuretics and cardiac glycosides are used excessively. In the case of excess use of antihypertension medications there is a big risk of developing arterial hypotension. In old people it may lead to orthostatic hypotension, in youth - to dizziness. The frequent use of diuretics in old people may be accompanied with dehydration and risk of developing thromb formation. Hyponatraemia, hypokalaemia, hypomagnesemia lead to heart rhythm disturbances and risk of glycoside intoxication. In old people the therapeutical doses of diuretics depend not only on their biological activity, but also on the ability of their absorption from the gastrointestinal tract, on the organism's resistance and in the case of repeated intake on their cumulation quality and extraction.