What should the phlebologist know from geriatrics

The treatment of elderly and very old patients presents a considerable challenge in addition to the difficult diagnosis by superimposed comorbidities and geriatric syndromes, especially in pharmacotherapy. In addition to physiological aging effects, these patients exhibit the highest exposure to pharmaceuticals, while the number of participating doctors increases with the consequence of a generally incomplete knowledge of the substances taken. In the context of phlebological treatment, therefore, the knowledge of the most important potentially risky medications is helpful, especially in the field of anticoagulation and potentially dangerous interactions with ECG changes. In the case of unacceptable combinations, electronic interaction checks should therefore always be carried out. The therapeutic principle of starting with old patients with low doses and only slowly increasing them to the target dose in order to take account of the changed distribution volumes and the altered elimination lead is useful. The first dose should not be reduced in antibiotic therapy in order to achieve adequate serum levels at an early stage. In the case of failure of a therapy, the possibility of non-intentional non-compliance in mild cognitive disorders should always be considered and, if necessary, further clarified. The early integration of geriatric therapy concepts should be considered to avoid everyday functional limitations.