Summary
Superimposed comorbidities and geriatric syndromes not only make the investigation
and diagnosis of elderly and very old patients more difficult, but also present a
considerable challenge to treatment, especially with regard to pharmacotherapy. Besides
experiencing the physiological effects of ageing, these patents show the highest exposure
to medication. At the same time, the number of doctors involved in their treatment
increases, which generally results in an incomplete knowledge of all the drugs being
taken. In the context of phlebological treatment, it is therefore helpful to know
about the most important potentially risky medications, especially where anticoagulants
are concerned, and about possible hazardous interactions with ECG changes. If the
compatibility of a particular combination is not known, an electronic drug interaction
check should always be carried out.
Starting elderly patients at a low dosage and slowly titrating the dose to reach the
target dose is a useful therapeutic principle, so that the altered distribution volumes
and elimination capacity can be taken into account. An exception is made for antibiotic
therapy, in which case the first dose should not be reduced, so that adequate serum
levels can be achieved at an early stage.
If treatment fails, the possibility of unintentional non-compliance due to mild cognitive
impairment must always be considered and assessed if necessary. The early integration
of geriatric treatment concepts should be considered to avoid everyday functional
restrictions.
Keywords
Geriatrics - pharmaceuticals for comorbidities
