Five principles of rational use of medication for the elderly 1, the available drugs can be used without the consultation should try to let the doctor fully understand the history of the disease and the current use of drugs, in order to make a correct diagnosis, and on this basis to clarify the indications for the use of drugs, reasonable choice of drugs. Except for emergencies and organic lesions, medication should be minimized; for drugs that can be used or not, it is better not to use them. For example, when symptoms such as insomnia and depression occur, adjustment of living habits, living environment and interpersonal relationships can be preferred. Elderly constipation is a fairly common symptom, can be improved by eating fiber-rich food, strengthen the abdominal muscle exercise, try not to rely on drug treatment means. 2, try to use the oral mode of drug delivery elderly patients using oral drug delivery, both convenient and economic, if possible, try not to use injectables. Controlled-release formulations are less affected by the dynamics of the gastrointestinal tract and acidity and alkalinity, and are more suitable for the elderly. If infusion must be used, the rate of administration should be determined according to the patient’s age, condition, and drug characteristics, generally at 20 to 40 drops/min. The optimal dose of medication is the minimum effective amount. The dose of medication varies greatly among different age groups, and even among different individuals of the same age group of elderly people, the dose varies a lot. With the exception of vitamins, trace elements and digestive enzymes, most medications for the elderly require dose adjustments. For example, antipyretic and analgesic drugs have a strong analgesic effect on the elderly, and the duration of the effect of the same dose can be several times longer than that of young people, so the dose should be reduced and the interval between dosing extended. Generally, 1/2 to 3/4 of the adult dose is used, or 1/3 to 1/2 of the adult dose can be used as the starting dose, and then slowly increased to the maintenance treatment amount. It should be noted that there is a common phenomenon of multiple drugs, and sometimes there may be many drugs with different trade names containing the same drug ingredients, which can lead to overdose if used repeatedly inadvertently. Some drugs that are prone to accumulation poisoning, dependence and addiction, such as barbiturates, diazepam, nitrazepam, etc. should be discontinued in a timely manner. Glucocorticosteroids should have a gradual process of dose reduction and discontinuation, and should not be stopped suddenly. Drugs that require consolidation of efficacy and relapse prevention, such as propylthiouracil and methimazole for the treatment of hyperthyroidism, anti-tuberculosis treatment drugs, antibacterial drugs for the treatment of serious infectious diseases, etc., should be extended for an appropriate period of time. 3, reduce the variety of joint medication The increase in the variety of joint medication, adverse reactions will also increase significantly, and there may be adverse drug interactions, affecting drug efficacy, increasing the risk of drug use, which is particularly prominent in the elderly. The minimum number of drugs and the lowest effective dose should be used, and no more than four drugs should be combined at the same time. The use of multiple medications may be required in critically ill elderly patients and should be gradually reduced after stabilization. The combination of drugs with the same type of action or similar adverse reactions is more likely to produce serious adverse reactions, so these drugs should be avoided at the same time, such as anticoagulant and blood-activating aspirin tablets, dipyridamole tablets, dipyridamole tablets, compound salvia tablets; antihypertensive drugs such as Beijing antihypertensive 0 tablets, nifedipine tablets, metoprolol tablets and terazosin tablets. Daily, you should learn more about the interactions that exist between some drugs commonly used in the elderly, such as the metabolism of warfarin can be increased by the enzyme-inducing effects of antiepileptic drugs, which can alter the prothrombin time. Antidepressants, antipsychotics, anticholinergics and antihistamines all have anticholinergic effects, and the combined effects can cause dry mouth, blurred vision, constipation and various psychiatric symptoms. The combination of diuretics, antihypertensives and vasodilators can easily lead to hypotension in the elderly and should be minimized. The central nervous system is more prone to dysfunction in old age, and the combination of two or more central depressants can cause excessive sedation and ataxia, and if the dose is not properly adjusted, it can lead to confusion, especially in the early morning and at night. The combination of isoniazid and phenytoin sodium may aggravate the central adverse effects of phenytoin sodium. Cardiac toxicity can be increased by low potassium when cardiac glycosides are combined with potassium-depleting diuretics, and attention should be paid to timely potassium supplementation to prevent arrhythmia. 4, be careful with new drugs and toxic side effects of the drug early application of new drugs on the market, can be seen as a larger scale clinical validation, during which serious adverse events may still occur, such as ketoconazole to liver damage, Bystein to rhabdomyolysis, Wanluo to vascular accidents, etc., so new drugs are not good drugs, must be selected when you should pay attention to record the use of drugs and monitor adverse drug reactions. There are many drugs used for the elderly with enhanced adverse reactions, and can even cause serious toxic reactions, should be used with caution; for long-term clinical use, the efficacy of the exact but toxic side effects of drugs, such as sulfonamides, streptomycin, kanamycin, gentamicin, phenytoin sodium, carbamazepine, valium, doxepin, raglan polyglucoside, digoxin, aspirin, indomethacin, ibuprofen, etc., when the condition requires Use with caution when selecting. Allergy medications are prohibited. The elderly should keep a detailed medical history and medication records. If you are allergic to a certain drug, be sure to know the ingredients of the drug you are using when you choose it. Especially when the drug used is displayed under a trade name, you should read the drug instructions carefully to understand the composition of the drug. In addition to the common rash, nausea, vomiting and other general symptoms, more common elderly-specific existing psychiatric symptoms, easy to fall, urinary and fecal incontinence, inactivity, loss of life skills, etc.. Usually, drugs that are used more frequently and often in combination with other drugs are central nervous system drugs, cardiovascular system drugs, antipyretic and analgesic drugs, anti-infective drugs, diuretics, etc. Therefore, special attention should be paid when choosing these types of drugs. For example, the aging of the body makes the function and tolerance of the nervous and mental systems deteriorate, and the central nervous system is more prone to dysfunction than other systems. When using sedatives and sleeping drugs, the dose should be adjusted, the interval should be extended, and short-acting drugs should be used as much as possible; when using high-efficiency broad-spectrum antibiotics and a long course of treatment, the liver, kidney and hematopoietic functions should be monitored, and attention should be paid to preventing secondary infections. The elderly are prone to postural hypotension and dizziness due to their reduced ability to regulate themselves and the insensitivity of pressure receptors to hypotension.