The Rx Consultant 

Drug Therapy in Elders: Clinical Tips

This CE activity was originally published in The Rx Consultant.  If you received credit for it previously, you cannot receive credit for it again.
Nearly 30% of older adults (aged 57-85) use 5 or more prescription medications concurrently – a key reason they are particularly susceptible to adverse drug events. Older adults are 4 to 7 times more likely than younger persons to experience adverse drug events that cause hospitalization. About 27% of the adverse drug events that occur in individuals 65 years of age or older are considered preventable.

The use of medications in elders is complex, with many factors contributing to medication problems. Polypharmacy (or “polymedicine”) is a broad term that can include the use of unnecessary and/or potentially inappropriate medications (PIMs). Age-related pharmacokinetic and pharmacodynamic changes – in addition to coexisting conditions (including physical disability and cognitive impairment) – contribute to a higher risk of adverse drug events. There are also more subtle underlying factors. Older individuals are frequently excluded from pre-marketing clinical trials and, as a result, approved indications and doses for medications may not be applicable to this population. The usefulness of clinical practice guidelines may be limited as well, because they are often based on evidence from studies that excluded either all older adults or older adults with multiple coexisting conditions.

This issue presents a brief update of age-related pharmacokinetic and pharmacodynamic considerations, drugs that should be avoided in older patients, and drugs that are likely to interfere with cognition and memory. Finally, you’ll find practical tips on drug therapy for several health conditions that are common in elders. Throughout, our goal is to provide you with practical tools you can use to optimize drug therapy for our elderly population.
This CE activity is a monograph (PDF file).



CE Hours


CE Units


Activity Type


Target Audience(s)

Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, and Registered Nurses


This CE activity was developed by The Rx Consultant, a publication of Continuing Education Network, Inc.

CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours.  CE credit is automatically reported to CPE Monitor.
CE activities for Nurse Practitioners and Clinical Nurse Specialists: 
    This continuing education activity meets the requirements of:
        The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
        The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
    This is a pharmacotherapeutics/pharmacology CE activity.
  • The ANCC requires all advanced practice nursing certificants (CNSs and NPs) to complete 25 CE hours of pharmacotherapeutics as a portion of the required 75 continuing education hours.
  • Pharmacology CE is recommended by the AANPCP and will be required for Certificants renewing certification starting January 2017.  
  • Most State Boards of Nursing require a minimum number of pharmacy contact hours to renew an advanced practice license.
Accreditation Council for Pharmacy Education
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Requirements for CE Credit

CE No Longer Valid
To receive CE credit, the participant must read the monograph in its entirety, complete the online post-test and receive a score of 70% or greater, and complete the online evaluation.
Pharmacists and Pharmacy Technicians -
Be sure your profile has been updated with your NAPB e-profile # and birth date information BEFORE completing the online evaluation, or your credits cannot be reported to CPE Monitor.
Continuing pharmacy education credit is automatically reported to CPE Monitor once the post-test & evaluation are successfully completed.




  • Discuss the Beers criteria for potentially inappropriate medications (PIMs) in elders. List 2 PIMs in each of 3 different classes that should be avoided in elders.
  • List at least 4 drug classes that have strong anticholinergic properties. List at least 4 other drug classes that can impair cognition in elders. Give 1-2 examples of drugs in each class.
  • Discuss at least 1 important drug therapy management strategy in elders for each of the following: dementia, depression, insomnia, and seizure disorders.


Pamela Mausner, MD

Brief Bio : Pamela Mausner, MD; Medical Writer/Editor and Healthcare Advocate; and Associate Editor, The Rx Consultant.
Disclosure : Dr.Mausner reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

R. Ron Finley, BS Pharm, RPh, CGP

Brief Bio : R. Ron Finley, BS Pharm, RPh, CGP, Clinical Pharmacist, UCSF Memory and Aging Center, San Francisco, and Consultant Pharmacist, Brain Health Center, Sutter Health, Davies Campus, San Francisco, CA.
Disclosure : Ron Finley is a member of the Speakers Bureau for Novartis Pharmaceuticals. Dr Finley report no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Tracy Farnen, PharmD

Brief Bio : Tracy Farnen, PharmD; Managing Editor, The Rx Consultant.
Disclosure : Dr. Farnen reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Activity Number


Release Date: May 18, 2013
Credit Expiration Date: May 18, 2016

CE Hours