Hopohopo e pili ana i nā lāʻau lapaʻau i hāʻawi ʻia i ka poʻe ʻelemakule? E kamaʻilio kākou e pili ana i nā 'Beers Criteria'!

Inā he ʻelemakule kou ma kou home, e like me kou makuahine, makuakāne, kupuna wahine, a kupuna kāne paha, e noʻonoʻo iki paha ʻoe i nā lāʻau lapaʻau āu e hāʻawi ai iā lākou, ʻeā? I kekahi manawa ke hele mākou i ke kauka, kuhikuhi lākou i nā ʻano lāʻau like ʻole . Akā i ko mākou ʻelemakule ʻana, loli ke ʻano o ka pane ʻana o ko mākou kino i nā lāʻau lapaʻau, a ʻaʻole kūpono paha kekahi mau lāʻau lapaʻau iā lākou. Aia kahi papa inoa o nā alakaʻi e kōkua i nā kauka e mālama i ia mau mea. ʻO ia ka mea a mākou e kapa nei ʻo 'Beers Criteria.' E kamaʻilio kākou e pili ana i kēia i kēia lā.

He aha kēia 'Nā Pae Hoʻohālikelike Pia'?

I ka ʻōlelo maʻalahi, he papa inoa kēia o nā alakaʻi i hoʻomohala ʻia e ka American Geriatrics Society , he hui o nā loea i ke olakino o ka poʻe ʻelemakule. Hōʻike ia iā mākou i nā lāʻau lapaʻau e hōʻino paha i ka poʻe ma luna o 65 mau makahiki, a i ʻole nā ​​​​lāʻau lapaʻau e loaʻa nā hopena ʻaoʻao ma mua o nā pono. Ua kapa ʻia kēia papa inoa ʻo 'Beer's List'. E noʻonoʻo e pili ana i ia mea, ua hōʻike ʻia nā noiʻi he ʻoi aku ma mua o 90% o ka poʻe ma luna o 65 mau makahiki e hoʻohana ana i hoʻokahi lāʻau lapaʻau i kēlā me kēia mahina, a ʻoi aku ma mua o 66% e hoʻohana ana ma mua o ʻekolu mau lāʻau lapaʻau. No laila, i ka manawa e like me kēia, e kōkua nui kēia papa inoa i nā kauka e kuhikuhi palekana i nā lāʻau lapaʻau.

He aha nā kumu nui ʻelima i loko o nā 'Beers Criteria'?

Hoʻokumu ʻia kēia papa inoa ma luna o ʻelima mau kumu nui, a nā kauka e noʻonoʻo nui ai i ka wā e kuhikuhi ana i kahi lāʻau lapaʻau no kahi kanaka ʻelemakule:

• ʻO nā lāʻau lapaʻau ʻaʻole pono e hāʻawi ʻia i nā poʻe ma luna o 65 mau makahiki, ʻoiai ka poʻe i loaʻa ʻole ka mālama hopena o ke ola e like me ka hospice a i ʻole ka mālama palliative .
• Nā lāʻau lapaʻau e hiki ke hoʻopōʻino i ka poʻe me kekahi mau kūlana olakino (e laʻa me ka maʻi puʻupaʻa, ka maʻi puʻuwai).
• Nā lāʻau lapaʻau e hoʻoulu ai i nā pilikia ma o ka hoʻoulu ʻana i nā pilina lāʻau i ka wā e lawe ʻia ai me nā lāʻau lapaʻau ʻē aʻe.
• Nā lāʻau lapaʻau e hiki ke hoʻopilikia ma mua o ka maikaʻi ma muli o nā hopena ʻaoʻao .
• Pono e hāʻawi ʻia nā lāʻau lapaʻau e hoʻopilikia ai i ka hana o nā puʻupaʻa (ʻo ia hoʻi, nā mea me ka maʻi puʻupaʻa) i nā palena palena a i ʻole e hoʻōki loa ʻia.

He aha ke ʻano o nā lāʻau lapaʻau ma ka papa inoa 'Beers Criteria'?

Aia ma kahi o 100 mau ʻano lāʻau lapaʻau ma kēia papa inoa. He paʻakikī ke kamaʻilio e pili ana iā lākou āpau, akā no ka hāʻawi ʻana iā ʻoe i kahi manaʻo, e nānā kākou i kekahi mau laʻana mai kekahi mau ʻano. I ka manawa like, e nānā kākou i nā kumu e hiki ai i kēlā mau lāʻau lapaʻau ke hōʻino.

• Nā lāʻau lapaʻau analgesics: No ka laʻana, nā lāʻau lapaʻau e like me `(meperidine)`. Hiki i kēia mau mea ke lilo i mea ʻawahia i ka ʻōnaehana nerve (`(Hiki nō hoʻi ke loaʻa ka neurotoxicity ()) a me ka delirium (`(delirium)`) .
• Nā lāʻau antibiotic: ʻO kekahi mau lāʻau antibiotic, no ka laʻana ciprofloxacin, hiki ke hoʻonui i ka pilikia o ke kahe koko ke lawe ʻia me ka warfarin (kahi mea hoʻokahe koko).
• Nā lāʻau lapaʻau antiseizure: Hiki i nā lāʻau lapaʻau e like me ka carbamazepine ke hana i kahi maʻi i kapa ʻia ʻo SIADH - Syndrome o ka hoʻokaʻawale ʻana o ka hormone antidiuretic inappropriate, kahi e hoʻopilikia ai i ke kaulike wai a me ka paʻakai o ke kino.
• Nā Antihistamines (nā ʻano kahiko): Hiki i nā lāʻau lapaʻau e like me ka brompheniramine ke hoʻoulu i ka huikau, ka hemahema o ka noʻonoʻo , a me ka delirium .
• Kekahi mau lāʻau lapaʻau no ke koko kiʻekiʻe (Antihypertensives): Hiki i kekahi mau lāʻau lapaʻau, e like me `(alpha-blockers),` ke hoʻoulu i ka emi koke ʻana o ke koko (`(Hypotension)`) .
• Nā Antiplatelets a i ʻole nā ​​​​​​anticoagulants: Hiki i nā lāʻau lapaʻau e like me edoxaban ke hoʻopilikia i nā puʻupaʻa (renal impairment) .
• Nā lāʻau antipsychotics: Hiki i kekahi lāʻau lapaʻau ma kēia papa ke hoʻonui i ka pilikia o ka hahau ʻana, ka emi ʻana o ka ʻike , a me ka delirium ke hāʻawi ʻia i nā pākeke.
• Nā lāʻau lapaʻau anxiolytics: Hiki i nā lāʻau lapaʻau i loko o ka hui benzodiazepines (e like me diazepam) ke lohi i ka uhaki ʻana o ke kino i ka lāʻau lapaʻau, hoʻemi i ka makaʻala, a hoʻoulu i ka haʻalulu i ka wā e hele ana .
• ʻO kekahi mau lāʻau lapaʻau puʻuwai: Hiki i nā lāʻau lapaʻau e like me ka disopyramide ke hoʻonui i ka hāʻule ʻana o ka puʻuwai .
• Nā mea hana o ka ʻōnaehana nerve waena: Hiki i ka Dimenhydrinate (loaʻa i loko o kekahi mau antiemetics) ke hoʻoulu i ka huikau, ka emi ʻana o ka ʻike, a me ka delirium .
• ʻO kekahi mau lāʻau lapaʻau maʻi diabetes: ʻO nā lāʻau lapaʻau kahiko e like me ka chlorpropamide hiki ke hoʻohaʻahaʻa i ke kō koko (hypoglycemia) .
• Nā lāʻau lapaʻau ʻōpū: Hiki i kekahi mau lāʻau lapaʻau i ka papa "H2-blocker" ke hoʻonui i ka delirium, ʻoiai inā loaʻa mua i kekahi .
• Nā Hormones: Ke hoʻokomo ʻia ka estrogen ma waho, hiki i kekahi mau wahine ke piʻi aʻe ka pilikia o ka maʻi ʻaʻai umauma a me ka maʻi ʻaʻai ʻōpū .
• ʻO kekahi mau lāʻau hiamoe (hypnotics): Aia kahi pilikia o ka hoʻohui ʻana i nā lāʻau lapaʻau e like me barbiturates a ʻo ka overdose hiki ke alakaʻi i nā kūlana weliweli .
• Nā mea hana musculoskeletal (nā mea hoʻomaha uaua): Hiki i kēia ke hana i nā mea e like me ka huikau, ka waha maloʻo, a me ka paʻa ʻana o ka ʻōpū .
• Nā lāʻau anti-inflammatory non-steroidal (NSAID): ʻO nā lāʻau lapaʻau e like me ka aspirin (ʻoi aku ma mua o 325 milligrams i kēlā me kēia lā) hiki ke hana i nā kūlana koʻikoʻi e like me nā ʻōpū ʻōpū, ke kahe ʻana o ke koko, a i ʻole ka perforation .
• ʻO kekahi mau lāʻau lapaʻau hanu: Hiki i nā lāʻau lapaʻau e like me ka atropine ke hoʻoulu i ka huikau, ka emi ʻana o ka ʻike, a me ka delirium .
• ʻO kekahi mau lāʻau lapaʻau mimi: hiki i ka "(desmopressin)" ke hoʻohaʻahaʻa i nā pae sodium koko ( "(hyponatremia)" , he mea weliweli nō hoʻi ia.
• ʻO kekahi mau lāʻau lapaʻau e hoʻonui ai i nā kīʻaha koko (vasodilators): ʻAʻole paha e hāʻawi nā lāʻau lapaʻau e like me `(ergoloid mesylates)` i nā hopena i manaʻo ʻia .

Mea nui: He mau laʻana wale nō kēia. Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe. ʻOiai inā ua kuhikuhi ʻia kahi lāʻau lapaʻau ma kēia papa inoa, aia paha ke kumu no ia. No laila, mai hopohopo, e kamaʻilio mau me kāu kauka.

ʻEhia pinepine e hōʻano hou ʻia ai kēia papa inoa 'Beers Criteria'? Pehea e hana ʻia ai?

ʻAʻole kēia he papa inoa manawa hoʻokahi e waiho wale ʻia ma ka ʻaoʻao. Nānā a hōʻano hou ka American Geriatrics Society i kēia papa inoa ma kahi o kēlā me kēia ʻekolu makahiki.

Pehea e hana ʻia ai? Hana ʻia kēia me ka hoʻohana ʻana i ka ʻike hou loa mai nā noiʻi lapaʻau hou a me nā hoʻokolohua lapaʻau. Hōʻuluʻulu kahi hui o nā loea lapaʻau, nānā i ka papa inoa kahiko, a hiki ke wehe i kekahi mau lāʻau lapaʻau, hoʻohui i nā mea hou, a hoʻololi paha i nā ʻōlelo paipai e kū nei ma muli o nā hōʻike hou.

I ka manawa hea e hoʻohana ai nā kauka i nā 'Beers Criteria'?

He mea hana maʻamau kēia papa inoa a nā kauka e hoʻohana ai i ke kuhikuhi ʻana i nā lāʻau lapaʻau no ka poʻe ma luna o 65. Akā, ʻaʻole ia he mea āu e nānā wale ai a hoʻoholo ai. E noʻonoʻo kāu kauka i kāu mōʻaukala lapaʻau piha, kou olakino o kēia manawa, a me nā lāʻau lapaʻau ʻē aʻe, nā huaora, a me nā mea hoʻohui āu e lawe nei . A laila e hoʻoholo lākou inā palekana kahi lāʻau lapaʻau hou a i ʻole ka nui o ka lāʻau lapaʻau o kēia manawa no ʻoe. Pono paha lākou e hoʻololi i ka lāʻau lapaʻau, ka nui, a i ʻole ka pinepine o ka lawelawe ʻana ma muli o kēia papa inoa.

He aha nā mea e noʻonoʻo ai i ka wā e hoʻohana ai i nā 'Beers Criteria'?

He nīnau koʻikoʻi loa kēia. He aha nā 'Pili Hoʻohālikelike Beers'?Ua hoʻolālā ʻia no kahi heluna nui. No laila, ʻaʻole ia he "kanaka kikoʻī" . ʻO ia hoʻi, ʻaʻole kēia papa inoa e pili ana i ke olakino laulā o ke kanaka, nā maʻi ʻē aʻe i loaʻa iā lākou, a i ʻole nā ​​​​kumu kikoʻī i alakaʻi ai i ke kauka e koho i kahi lāʻau lapaʻau.

No laila, he mea hana maikaʻi wale nō kēia no nā kauka e hoʻohana. ʻAʻole ia e hoʻoholo no ke kauka akamai a ʻike.

Eia kekahi laʻana, inā makemake ke kauka e hāʻawi iā ʻoe i kahi lāʻau lapaʻau ma kēia papa inoa i manaʻo ʻia he mea hōʻino paha, e noʻonoʻo ʻo ia i nā mea he nui, me kou olakino a me ke kaiapuni e mālama ʻia nei ʻoe. A laila wale nō e hoʻoholo ai ʻo ia i ka hoʻoholo hope loa inā palekana ka lāʻau lapaʻau iā ʻoe. I ka hapanui o nā hihia, hiki i nā kauka ke koho i kahi koho ʻē aʻe i kahi lāʻau lapaʻau ma kēia papa inoa. Eia nō naʻe, inā ua kuhikuhi ʻia kahi lāʻau lapaʻau ma kēia papa inoa, e nānā pono ke kauka iā ʻoe e ʻike inā he mau hopena ʻaoʻao.

No ke aha e loli ai ke ʻano o ka hopena o nā lāʻau lapaʻau i ko mākou kino i ko mākou wā ʻelemakule?

He mea nui loa kēia. I ko kākou ʻelemakule ʻana, nui nā loli i ko kākou kino. Hiki i kēia mau loli ke hoʻopilikia i ke ʻano o ka komo ʻana o nā lāʻau lapaʻau a me kā lākou hana ʻana i loko o ko kākou kino. Eia kekahi mau laʻana:

• ʻOi aku ka lōʻihi o ke kino e wāwahi ai (metabolize) a hoʻopau i ka lāʻau. ʻO ke ʻano kēia e noho lōʻihi paha ka lāʻau i loko o kou kino. ʻO ia ke kumu e hāʻawi pinepine ai nā kauka i nā poʻe ʻelemakule i nā lāʻau lapaʻau haʻahaʻa.
• Hiki i kahi lāʻau lapaʻau no kekahi maʻi ke hoʻopilikia i kekahi. Ma muli o ka hoʻololi ʻana o kekahi mau lāʻau lapaʻau i ke ʻano o ka pane ʻana o ko mākou kino, hiki iā lākou ke hoʻopilikia i ka hana maikaʻi o nā lāʻau lapaʻau ʻē aʻe.
• Nā loli o ke ʻano o ka nohona. Hiki i nā mea e like me kou pae hana a me ka papaʻai āu e ʻai ai ke hoʻopilikia i ka hana maikaʻi o kekahi mau lāʻau lapaʻau. No laila, ke ʻike ʻoe i ke kauka, he mea nui e kamaʻilio e pili ana i kāu hana maʻamau i kēlā me kēia lā, nā mea āu e ʻai ai, a inā paha ʻoe e hoʻoikaika kino. Ma kēlā ala, hiki iā ia ke koho i ka lāʻau lapaʻau kūpono loa iā ʻoe.

Ua ʻike maikaʻi nā kauka i ko kākou kino a pehea lākou e loli ai me ka makahiki. Inā hāʻawi lākou iā ʻoe i kahi lāʻau lapaʻau, e nānā lākou i ke ʻano o ka pane ʻana o kou kino iā ia e hōʻoia i ka palekana.

No laila, he aha nā mea e pono ai kākou e hoʻomanaʻo mai kēia moʻolelo?

ʻAe, i kēia manawa ua maopopo paha iā ʻoe ʻo nā 'Beers Criteria' a mākou i kamaʻilio ai he papa inoa o nā alakaʻi koʻikoʻi e kōkua i nā kauka i ke kuhikuhi ʻana i nā lāʻau lapaʻau i ka poʻe ma luna o 65 mau makahiki.

Kōkua kēia i nā kauka e kālele i nā lāʻau lapaʻau i hiki ke hōʻeha i kahi kanaka ʻelemakule a koho i nā koho ʻē aʻe palekana.

E hoʻomanaʻo, he mea hana kēia no nā kauka, ʻaʻole ia he mea āu e hoʻohana ai e hoʻōki a hoʻomaka paha i ka lāʻau lapaʻau ma kāu iho.Inā he mau nīnau a hopohopo paha kāu e pili ana i kahi lāʻau lapaʻau āu e lawe nei, e ʻoluʻolu e kamaʻilio me kāu kauka. ʻO ia ke kanaka maikaʻi loa e hāʻawi iā ʻoe i nā ʻōlelo aʻoaʻo pololei. ʻO ka hoʻolohe ʻana i kou mau manaʻo ponoʻī ke ala maikaʻi loa e noho olakino ai.

Nā Pae Hoʻohālikelike no nā Pia, Ola Kino o nā Mākua, Nā Lāʻau Lapaʻau, Nā Hopena ʻAoʻao, Nā Lāʻau Lapaʻau Palekana, Ka ʻElemakule