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Cardiovascular drug therapy in the elderly
W S Aronow1, W H Frishman, A Cheng-Lai
1Department of Geriatrics and Adult Development, Mt. Sinai Medical School, New York, NY, USA.
Heart Disease (Hagerstown, Md.)
|December 1, 2001
Summary
Cardiovascular drug prescribing for older adults requires careful consideration due to age-related physiological changes and polypharmacy. Special attention is needed for drugs like digoxin, lidocaine, and warfarin to prevent toxicity and drug interactions.
Area of Science:
- Geriatrics
- Cardiology
- Pharmacology
Background:
- Cardiovascular diseases are highly prevalent in the elderly population.
- Aging significantly impacts drug absorption, distribution, metabolism, and excretion.
- Older patients frequently use multiple medications, increasing the risk of drug interactions.
Purpose of the Study:
- To highlight pharmacologic issues in elderly cardiovascular drug therapy.
- To provide recommendations for safe prescribing of cardiac drugs in older patients.
Main Methods:
- Review of age-related pharmacokinetic and pharmacodynamic changes.
- Identification of high-risk cardiovascular drugs for the elderly.
- Analysis of potential drug-drug interactions in geriatric patients.
Main Results:
- Age-related changes necessitate dosage adjustments for many cardiovascular drugs.
- Drugs such as digoxin, lidocaine, and warfarin pose a higher toxicity risk in older adults.
- Polypharmacy significantly elevates the risk of adverse drug events and interactions.
Conclusions:
- Safe prescribing of cardiac drugs in the elderly demands a thorough understanding of aging effects on drug response.
- Careful medication review and monitoring are crucial to mitigate risks associated with cardiovascular pharmacotherapy in geriatric patients.
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