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[Pharmacokinetics and the aged person].

J P Fillastre1, B Moulin, M Dhib

  • 1Service de Néphrologie, CHU de Rouen.

Nephrologie
|January 1, 1990
PubMed
Summary

Elderly individuals experience altered drug pharmacokinetics due to age-related physiological changes, necessitating cautious prescribing. Lower dosages and gradual increases are recommended to prevent adverse drug reactions in older patients.

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Area of Science:

  • Gerontology
  • Pharmacology
  • Internal Medicine

Background:

  • Aging is associated with visceral functional declines, impacting drug pharmacokinetics.
  • Gastrointestinal, hepatic, and renal functions undergo age-related modifications.
  • Changes in plasma protein binding and body composition also affect drug distribution.

Purpose of the Study:

  • To review age-related pharmacokinetic alterations in elderly subjects.
  • To highlight the implications of these changes for drug prescribing.
  • To provide recommendations for safe medication management in older adults.

Main Methods:

  • Review of age-related physiological changes affecting drug absorption, distribution, metabolism, and excretion.
  • Analysis of how diminished gastric acid secretion, motility, intestinal surface, and blood flow impact drug absorption.
  • Examination of reduced plasma protein binding, lean body mass, hepatic function, and renal excretion in the elderly.

Main Results:

  • Age-related decreases in gastric acid secretion, motility, intestinal surface area, and blood flow can alter drug absorption.
  • Reduced plasma protein levels and decreased lean body mass lead to higher drug plasma levels.
  • Diminished hepatic clearance and reduced renal excretion can result in drug accumulation and potential toxicity.

Conclusions:

  • Pharmacokinetic alterations in the elderly necessitate careful drug prescription.
  • Starting with low dosages and increasing them progressively is advised.
  • Close monitoring for clinical and biological signs of intolerance is crucial in elderly patients.

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