ABSTRACT

Older adults as well as other vulnerable patients are particularly susceptible to the deleterious effects of polypharmacy and related inappropriate prescribing practices common in contemporary medicine. This chapter provides an overview of prescribing practices for the older adult, emphasizes selected classes of medications commonly encountered in physiatric practice, and outlines strategies for rational medication management. It describes the clinical appropriateness of specific medications and the interactions of multiple medications in the face of rapidly aging population. Rehabilitation physicians frequently manage complex patients with several comorbid conditions and on multiple medications. When caring for older patients, the changes in physiology and drug metabolism are important to keep in mind and consider in the context of each prescription, as well as comprehensive medication list assessments. The variety of commonly used pain medications ranges from topical analgesics to intravenous opioids.