SAFETY ISSUES IN THE PHARMACOLOGICAL MANAGEMENT OF CHRONIC PAIN IN THE ELDERLY

Chronic pain is commonly encountered in elderly patients. About 20-50% of community-dwelling elderly experience it, and 45-80% of nursing ho me residents may be affected. Selection of pharmacologic therapy for t he management of chronic pain must take into consideration the increas ed potential for adverse effects in this population. Major classes of drugs used to treat chronic pain (nonsteroidal antiinflammatory drugs, opioids, antidepressants) have adverse effects that occur more freque ntly in elderly than in younger patients. Given the often prolonged du ration of therapy, optimal management requires minimizing the risk of adverse reactions.