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Related Experiment Videos

Pharmacokinetics in older persons.

Barry J Cusack1

  • 1Gerontology and Pharmacology Research Unit, VA Medical Center, Boise, Idaho 83702, USA. barry.cusack@med.va.gov

The American Journal of Geriatric Pharmacotherapy
|May 21, 2005
PubMed
Summary

Aging alters drug pharmacokinetics, affecting absorption, distribution, metabolism, and elimination. These age-related changes in drug handling necessitate careful dose adjustments in older adults, though individual factors often play a larger role.

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Area of Science:

  • Gerontology
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Aging leads to physiological changes and organ dysfunction, impacting drug pharmacokinetics in older individuals.
  • Understanding these age-related alterations is crucial for safe and effective medication use in the elderly.

Purpose of the Study:

  • To review age-related changes in pharmacokinetics (drug absorption, distribution, metabolism, and elimination).
  • To discuss the clinical relevance of these pharmacokinetic alterations in older persons.

Main Methods:

  • A comprehensive literature search was performed using PubMed with keywords 'elderly' and 'pharmacokinetics'.
  • Included studies primarily from 1990 to 2004, with earlier articles used for illustrative principles.

Main Results:

  • Minor changes in drug absorption; increased bioavailability of highly extracted drugs; altered drug distribution (wider for fat-soluble, less for water-soluble).
  • Age-related decline in hepatic drug metabolism (cytochrome enzyme system) and renal drug elimination (creatinine clearance); synthetic conjugation less affected.
  • Frailty, stress, and illness are significant predictors of drug metabolism, potentially overshadowing age-related pharmacokinetic shifts.

Conclusions:

  • Physiological changes with aging alter pharmacokinetics, influencing drug dosage requirements in older adults, especially for renally eliminated drugs.
  • Individual variability, disease, frailty, and stress are critical factors that can significantly impact drug response and may be more influential than age alone.

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