Polypharmacy in otolaryngologic secretory senescence

Abstract

The progressive aging of the population is a widely documented figure worldwide. Just as most individuals can lead longer lives, it is equally true that most of them experience a period of their life, specifically that of older age, characterized by the coexistence of multiple diseases. The growing number of elderly people with multimorbidity entails the need of treatment regimens that require the simultaneous administration of multiple drugs, in complex therapy regimens. This represents a real medical challenge, intended to an ever-increasing impact in the years to come. “Polypharmacy”, generally understood as the simultaneous use of multiple drugs in the same patient, is obviously the rational response to the treatment of complex pathological pictures in aged individuals. Conversely, this polypharmacy implies a growing concern regarding the inappropriate and not strictly necessary simultaneous intake of a large number of drugs. This situation can lead to an actual change in the benefits of each single drug towards adverse effects, when it is taken in combination with other drugs, in complex and prolonged therapeutic regimens. This is precisely the “heart” of the clinical problem of polypharmacy and the adverse effects it causes. These considerations are particularly felt in the Ear-Nose-Throat (ENT) field, in which the specialist, generally lacking an adequate doctrinal and clinical background in gerontology and geriatrics, is called to evaluate and treat complex pathological pictures that embrace and overlap in conditions of multimorbidity, in regime of polypharmacy. The following displayed order will be adopted to discuss this complex issue: current definitions of polypharmacy, current concepts of clinical pharmacology of the elderly, polypharmacy in ENT clinical practice and in the secretory senescence of head-neck structures.