Urologic Medication Concerns and Contraindications in the Elderly

The elderly population is an ever-growing special population which requires specific knowledge and understanding when prescribing certain medications. Especially susceptible to adverse events caused by medications, those individuals over 65 years of age are more amenable to the physiological and pharmacological changes of drugs in the body, and how they respond to drug therapy. Other factors such as drug interactions, renal function, polypharmacy, and compliance in the older population has an additive effect on the importance of provider surveillance and the value of strict monitoring. It is also not a coincidence that the use of prescribed and over-the-counter medication also increases with age. In this presentation, prescription drug entities in the field of urology will be discussed as they pertain to this special subset of patients. These include medication classes such as antimuscarinics, certain antibiotics (like nitrofurantoin and the quinolones), and medications for erectile dysfunction including the PDE5 inhibitors. Alpha blockers such as tamsulosin and the hormone desmopressin will also be discussed in terms of proper use and monitoring. Strict monitoring parameters and differentiators in these groups of patients will be discussed. Beers criteria updates and identification of those medications used in urology which are included on the Beers list will also be presented. Identifying those patients at risk along with the main drug culprits will provide the toolkit of information you need to properly differentiate which medications should be altered or avoided, and which are appropriate for use in the elderly.