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Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications
1Department of Health Care of the Elderly, Guy's, King's, and St Thomas' School of Medicine, King's College London, London. arduino.mangoni@kcl.ac.uk
British Journal of Clinical Pharmacology
|December 18, 2003
Summary
Aging impairs the body's ability to maintain balance, leading to significant changes in how drugs are processed (pharmacokinetics) and how they affect the body (pharmacodynamics). This review explores these age-related physiological shifts.
Area of Science:
- Gerontology
- Pharmacology
- Physiology
Background:
- Advancing age is associated with declining regulatory processes crucial for cell and organ integration.
- Reduced homeostatic mechanisms in older adults contribute to increased interindividual variability.
- Physiological stress can overwhelm the diminished homeostatic capacity in the elderly.
Purpose of the Study:
- To review age-related physiological changes across organ systems.
- To examine the impact of aging on drug pharmacokinetics and pharmacodynamics.
- To provide insights into altered drug responses in older populations.
Main Methods:
- Literature review of age-related physiological changes.
- Analysis of pharmacokinetic alterations (e.g., clearance, volume of distribution, half-life).
- Examination of pharmacodynamic shifts (e.g., drug sensitivity).
Main Results:
- Aging reduces renal and hepatic drug clearance.
- Increased volume of distribution for lipid-soluble drugs prolongs elimination half-life.
- Older adults exhibit altered, often increased, sensitivity to various drug classes.
Conclusions:
- Age-related physiological changes significantly impact drug pharmacokinetics and pharmacodynamics.
- Understanding these changes is vital for optimizing drug therapy in the elderly.
- Interindividual variability in aging necessitates personalized approaches to pharmacotherapy.