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Medication Side Effects and Elderly Patients

Aged Care

Updated 25-01-2024

Medication Side Effects and Elderly Patients

As the population ages, a pressing issue emerges within the healthcare realm—how do medication side effects affect elderly patients? Navigating the complexities of pharmacology in the senior demographic is not merely a concern; it's an imperative. The advanced age of such patients often means they're prescribed a multitude of medications, which consequently increases the risk of adverse reactions.

Elderly patients undergo several physiological changes that can significantly alter pharmacokinetics—the way the body absorbs, distributes, metabolises, and excretes medications. These changes may lead to a higher risk of side effects.

Altered Absorption

As we age, the efficiency of our digestive systems wanes. Gastric acidity levels reduce, gastrointestinal blood flow decreases, and motility diminishes. These challenges can affect the way medicine is absorbed, often requiring adjustments in dosage and administration methods.

Distribution Variances

Due to the natural decrease in lean body mass and body water coupled with an increase in body fat, there's a marked shift in the distribution of drugs. Lipid-soluble drugs may have an elongated effect, while water-soluble drugs may show increased concentration, requiring carefully calibrated dosages.

Metabolic Modifications

Liver size and hepatic blood flow progressively decline with age, which can impede the metabolism of drugs. Medications that rely on hepatic metabolism may accumulate to potentially harmful levels if not properly monitored.

Excretion Efficiency

Renal function deterioration is common in the elderly, impacting the elimination of medications and their metabolites. Prescribers must consider this when selecting drugs and determining doses to avoid toxicity.

The Challenge of Polypharmacy

Polypharmacy—the concurrent use of multiple medications—is common among older adults, increasing the risk of unwanted drug interactions and side effects.

Potential Drug Interactions

Each additional medication raises the potential for an interaction, pinching the therapeutic window between efficacy and toxicity. Drug-drug interactions can lead to diminished therapeutic effects or enhanced adverse reactions.

Increased Risk of Falls

Many medications, such as sedatives, antihypertensives, and antipsychotics, can increase the risk of falls in the elderly, a significant cause of morbidity and mortality in this demographic.

Cognitive Impairment

Polypharmacy can also contribute to cognitive impairment, with some medications having anticholinergic effects that affect memory and alertness, leading to decreased quality of life and independence.

Medication Review and Management

To mitigate these risks, a robust medication management process is essential.

Regular Reviews by Healthcare Professionals

Having periodic medication reviews with a healthcare professional can ensure that dosages are appropriate, necessary, and that medications are safely co-administered. It is critical for proactive identification of potential drug-related problems.

Medication Adherence Strategies

Assistance with medication adherence, such as simplified dosing schedules, the use of pill organisers, and educational reinforcements, is vital to mitigate the complexity and reduce the risk of errors.

Non-Pharmacological Alternatives

Whenever possible and sensible, consideration of non-pharmacological interventions to manage health conditions should be given as a first line approach, reducing the inherent risks associated with pharmacotherapy in elderly patients.


Comprehending and addressing medication side effects in elderly patients is a multifaceted and indispensable aspect of geriatric care. Individualised treatment plans, vigilant monitoring, and an understanding of the unique pharmacokinetic and pharmacodynamic changes within this group play a pivotal role in managing the delicate balance of treating conditions while minimising adverse effects. Only through dedication to tailored patient care, ongoing education, and interprofessional collaborations can we ensure the safest and most effective use of medications in our senior population.

About the Author

Olivia is a seasoned professional with an extensive career spanning the Aged Care sector, bringing decades of experience to her role. Her comprehensive understanding of Aged Care services and practices is a testament to her dedication. Olivia’s gratitude extends to those who have generously shared their knowledge and insights with her over the years, contributing to her wealth of expertise.

Olivia’s articles reflect her commitment to practical and informative content. They skillfully combine her industry know-how with real-world insights, providing valuable resources for navigating the complexities of the Aged Care sector. Olivia stands as a reliable advocate for delivering compassionate and effective care to elderly individuals, offering her support not only to fellow care workers and professionals but also to those seeking to gain a deeper understanding of the sector.

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