ABSTRACT
Older people account for a growing percentage of the UK population, and for around one-third of primary care workload and prescribing volume. Drug–drug interaction is one of the commonest causes of these admissions, along with patient confusion as to the dosage sequence of several concurrent prescriptions. Hyperkalaemia or hyponatraemia may be caused by chronic diuretic therapy without proper monitoring of blood electrolytes. Common to all patients over the age of 70 years are the physiological changes of ageing, leading to a gradual reduction in functional reserve in the cardiovascular, respiratory, renal, hepatic, musculoskeletal and central nervous systems, as well as the skin. The common prescription of NSAIDs for joint pain frequently accelerates this natural decline in renal function by inhibiting renal prostaglandin synthesis, causing tubular ischaemia and retention of sodium and water, which may in turn precipitate or worsen left ventricular failure.
