Page 1081 - Basic _ Clinical Pharmacology ( PDFDrive )

CHAPTER 60 Special Aspects of Geriatric Pharmacology 1067

Rabow MW, Pantilat SZ: Palliative care and pain management. In: Papadakis Steinman MA, Hanlon JT: Managing medications in clinically complex elders.
MA, McPhee SJ, (editors): Current Medical Diagnosis & Treatment 2017, JAMA 2010;304:1592.
McGraw-Hill, 2017. Teixeira A et al: Management of acute heart failure in elderly patients. Arch
Roberson ED, Mucke L: 100 years and counting: Prospects for defeating Cardiovasc Dis 2016;109:422.
Alzheimer’s disease. Science 2006;314:781. Vaillaint GE: Aging Well. Little, Brown, 2002.
Satizabal CL et al: Incidence of dementia over three decades in the Framingham Vandenberghe R et al: Bapineuzumab for mild to moderate Alzheimer’s disease
Heart Study. N Engl J Med 2016;374:523. in two global, randomized, phase 3 trials. Alzheimers Res Ther 2016;8:18.
Sawhney R, Sehl M, Naeim A: Physiologic aspects of aging: Impact on cancer Vik SA et al: Medication nonadherence and subsequent risk of hospitalisation and
management and decision making, part I. Cancer J 2005;11:449. mortality among older adults. Drugs Aging 2006;23:345.
Staskin DR: Overactive bladder in the elderly: A guide to pharmacological Wright JT Jr et al: A randomized trial of intensive versus standard blood-pressure
management. Drugs Aging 2005;22:1013. control. N Engl J Med 2015;373:2103.

C ASE STUD Y ANSWER

This patient has several conditions that warrant careful treat- rivastigmine, galantamine). Alternatively, memantine may be
ment. Hypertension is eminently treatable; the steps described tried. Unfortunately, age-related macular degeneration (the
in Chapter 11 are appropriate and effective in the elderly as well most likely cause of his visual difficulties) is not readily treated,
as in young patients. Patient education is critical in combating but the “wet” (neovascular) variety may respond well to one
his reluctance to take his medications. Alzheimer’s disease may of the drugs currently available (bevacizumab, ranibizumab,
respond to one of the anticholinesterase agents (donepezil, pegaptanib). However, these therapies are expensive.