Features of pharmacotherapy in the elderly patients. Introduction to the problem

Features of pharmacotherapy in the elderly patients are discussed. Data on the pharmacokinetics and pharmacodynamics, comorbidity, polypragmasy and treatment adherence among patients of this age group are presented

EFFICACY AND SAFETY OF LIPID-LOWERING DRUGS IN PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES IN THE ELDERLY

Effect of hyperlipidemia on morbidity and mortality in elderly patients is considered. Authors also cover issues of efficacy and safety of lipid-lowering therapy in primary and secondary prevention of cardiovascular diseases in patients ≥80 years of age who are the most quickly growing group of population and have the highest cardiovascular risk. They stress the need to take into account polymorbidity and polypharmacy that increase the risk of adverse reactions due to the use of both statins and their drug-drug interactions, which requires an assessment of risk/benefit ratio. In addition, there is a need for development of reliable prognostic tools to predict relevant outcomes (e.g., stroke, decrease in functionality/independence, quality of life reduction) and rationales for lipid-lowering therapy in the elderly and also their adherence to treatment

Physicians’ knowledge and preferences in tactics of management and rational pharmacotherapy of arterial hypertension in pregnant women (PHYGEST study)

The aim of the study: To determine the knowledge and preferences of physicians in the management of pregnant women with arterial hypertensio

PHARMACOTHERAPY OF ARTERIAL HYPERTENSION IN ELDERLY PATIENTS: FOCUS ON OCTOGENARIANS

Pharmacotherapy of arterial hypertension in the elderly is discussed. Russian and international guidelines are presented with a focus on target levels of blood pressure and drugs of choice in these patients. Issues of efficacy and safety of antihypertensive therapy in patients aged 80 years and older are considered

Antiarrhythmic Drugs Use in Elderly Patients. Vaughan Williams Class III and IV Drugs

The effectiveness of antiarrhythmic drugs in the elderly is similar to that in younger patients. However data for «the very elderly» are lacking. Elderly patients are more vulnerable to adverse drug reactions (ADRs) because of age-related changes of pharmacokinetics, co-morbidity and drug interactions. Аmioadarone is not considered as the drug of choice in elderly patients because of the high risk of serious ADRs. Other class III drugs should be prescribed to the elderly with great caution under close monitoring of the treatment. Diltiazem and verapamil should not be used in elderly patients with NYHA class III-IV heart failure and should not be combined with β-blockers

Antiarrhythmic drugs use in elderly patients. Vaughan Williams class I and II drugs

Use of class I antiarrhythmic drugs in the elderly is limited by their adverse drug reactions (ADRs), proarrhythmic effect (I A и I C) and high risk of drug interactions. Disopyramide use should be avoided due to its strong anticholinergic properties associated with the risk of cognitive and physical disorders and falls in the “very elderly” patients. Available data suggest that elderly patients do not have significant limitations for beta-blockers use. However to determine beta-blockers with the best benefit/risk ratio in elderly patients with co-morbidity further clinical trials are needed