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Geriatric Psychiatry pp 109–134Cite as

Pharmacotherapy: Safe Prescribing and Adverse Drug Events

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Abstract

Geriatric patients are likely to be treated with multiple medications for illnesses affecting many organ systems. The addition of psychotropic medication(s) to the regimens of patients already receiving many other medications must therefore be done only after consideration of the many factors that may affect safety and side-effects. These factors include side effects attributable to psychotropic medications themselves, drug-drug interactions, and considerations of age-related changes in drug absorption, pharmacokinetics, and pharmacodynamics. This chapter addresses the issues of polypharmacy in geriatric patients and the specific central nervous system and systemic side effects that need to be actively considered when prescribing psychotropic medications to treat various psychiatric illnesses. Because geriatric patients often have multiple clinicians prescribing medications for multiple illnesses, communication among clinicians and active use of pharmacy profiling are recommended to facilitate safe medication prescribing and monitoring.

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Notes

  1. 1.

    The metabolic syndrome is defined as meeting at least 3 of the 5 criteria: abdominal obesity, hypertriglyceridemia, low high-density-lipoprotein cholesterol, hypertension, and a fasting blood glucose >100 mg/dL (5.55 mmol/L).

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Authors and Affiliations

  1. Division of General Medicine, University of California Davis Medical Center, Sacramento, CA, USA

    Calvin H. Hirsch MD

  2. McMaster University, Hamilton, ON, Canada

    Shyam Maharaj

  3. Baylor Scott and White Department of Psychiatry, Texas A&M University College of Medicine, Temple, TX, USA

    James A. Bourgeois

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  1. Calvin H. Hirsch MD
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  2. Shyam Maharaj
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  3. James A. Bourgeois
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Correspondence to Calvin H. Hirsch MD .

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Editors and Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada

    Ana Hategan

  2. Baylor Scott and White Department of Psychiatry, Texas A&M University College of Medicine, Temple, Texas, USA

    James A. Bourgeois

  3. Division of General Medicine, University of California Davis Medical Center, Sacramento, California, USA

    Calvin H. Hirsch

  4. Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, California, USA

    Caroline Giroux

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Hirsch, C.H., Maharaj, S., Bourgeois, J.A. (2018). Pharmacotherapy: Safe Prescribing and Adverse Drug Events. In: Hategan, A., Bourgeois, J., Hirsch, C., Giroux, C. (eds) Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-67555-8_5

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