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Drug metabolism and ageing
1Department of Health Care of the Elderly, Guy's, King's, and St Thomas' School of Medicine, King's College London, London, UK. mark.kinirons@gstt.sthames.nhs.uk
Drug metabolism significantly changes with aging, affecting cytochrome P450 enzymes and transporters. Frail older individuals exhibit altered drug disposition compared to healthy elderly or young adults.
Area of Science:
- Pharmacology
- Gerontology
- Drug Metabolism
Background:
- Aging is associated with significant alterations in drug metabolism.
- Reductions in cytochrome P450 enzyme (CYP) function are observed in some, but not all, individuals.
- The impact of aging on drug transporters remains largely unexamined.
Purpose of the Study:
- To revisit the induction and inhibition of CYPs considering recent advancements.
- To investigate age-related effects on the function and pharmacology of drug transporters.
- To explore the relationship between frailty and drug metabolism/disposition in older adults.
Main Methods:
- Review of recent advances in CYP enzyme research.
- Examination of age-related changes in drug transporter function.
- Comparative analysis of drug metabolism and disposition in frail elderly, healthy elderly, and young individuals.
Main Results:
- Age-associated functional declines in certain CYPs are documented.
- Frailty in older adults is linked to reduced drug metabolism and altered drug disposition.
- Significant knowledge gaps exist regarding age-related transporter pharmacology.
Conclusions:
- Aging profoundly impacts drug metabolism, affecting both CYPs and transporters.
- Frailty represents a critical factor influencing drug disposition in the elderly.
- Further research is needed to fully elucidate age-related changes in drug disposition and inform clinical practice.
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