What phlebologists need to know about geriatric medicine

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

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