3 Casuïstiek 21
3.1 Casus 1 21
3.2 Casus 2 deel 5 minuut: 4:25 22
3.3 Casus 3 22
DEEL 3: POLYFARMACIE 23
1 Definities 23
2 Vaststellingen met betrekking tot polyfarmacie 23
2.1 Ongeschikt geneesmiddelengebruik 23
2.2 Acute ziekenhuisopname bij ouderen 23
2.3 Therapietrouw 24
2.3.1 Factoren die negatieve invloed hebben op therapietrouw 24
2.3.2 Interventies om therapietrouw te bevorderen 24
2.4 Interacties 24
2.4.1 Additief effect van geneesmiddelen 25
2.4.2 Antagonisme 26
2.4.3 Resorptie 26
2.4.4 Distributie 26
2.4.5 Metabolisatie 26
2.4.6 Excretie 27
2.5 Aandachtspunten geneesmiddeleninteracties 27
2.6 Mogelijke interventies om geneesmiddelninteracties te beperken 27
2.7 Tabellen betreffende geneesmiddelinteracties 28
2.7.1 Invloed geneesmiddelen / voeding op effect van vitamine K-antagonisten 28
2.8 Multimorbiditeit bij ouderen geeft aanleiding tot polyfarmacie 29
2.8.1 Optimaliseren geneesmiddelenvoorschrift/ polyfarmacie bij ouderen 29
3 Casuïstiek 30
3.1 Geneesmiddeleninteractie 30
3.2 Interindividuele variabiliteit 30
3.3 Farmacogenetica 31
3.4 Een goede uitleg is van groot belang 31
2
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