DRUG POISONING IN OLDER PATIENTS - PREVENTATIVE AND MANAGEMENT STRATEGIES

Children under 6 years of age are involved in the majority of poisonin gs. However, the elderly are more likely to require hospitalisation an d to die from poisonings compared with younger individuals, Drugs play an important role in the poisoning exposures of older patients, Analg esics, cardiovascular medications, theophylline preparations and antid epressants and other psychotropic medications are most commonly implic ated in drug poisoning fatalities in elderly Americans. Careful review of information which characterises drug poisonings in the elderly is essential to the development of effective preventative strategies. Mos t poison centre calls for elderly patients involve accidental exposure s, The ingestion of extra doses of medications because of forgetfulnes s, mistaken identity of medications, incorrect route of administration , and improper storage of medications are among the primary reasons fo r unintentional drug poisonings in older patients. A model for injury control composed of 3 phases can be applied to poison exposures in the elderly: activities in the pre-event phase focus on prevention; the g oal of the event phase is to minimise the chance of injury from exposu re if it should occur; the post-event phase is directed at appropriate management to reduce the consequences of injury from poison exposure once it occurs. The general management of drug poisonings is similar i n older and younger patients, However, management in the elderly is co mplicated by difficulties in the diagnosis of drug poisoning, pharmaco kinetic and pharmacodynamic changes associated with aging, increased i ncidence of chronic illness, and increased medication use with the pot ential for clinically significant drug interactions. Aggressive initia l treatment is imperative because the elderly are generally more Susce ptible to the toxic effects of drugs.