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Related Experiment Videos

Nonsteroidal anti-inflammatory drugs.

M D Murray1, D C Brater

  • 1Department of Pharmacy Practice, Purdue University School of Pharmacy and Pharmacal Sciences, West Lafayette, Indiana.

Clinics in Geriatric Medicine
|May 1, 1990
PubMed
Summary

Understanding NSAIDs in the elderly is crucial. New studies must consider unbound drug fractions, active enantiomers, and metabolite activity for safe and effective NSAID use in older adults.

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Area of Science:

  • Pharmacology
  • Geriatrics
  • Drug Metabolism

Background:

  • Limited understanding of NSAID pharmacokinetics and pharmacodynamics in the elderly.
  • Existing data on NSAIDs in older adults may be incomplete or misleading.
  • Need for comprehensive studies on drug disposition in aging populations.

Purpose of the Study:

  • To highlight the importance of age-related pharmacokinetic and pharmacodynamic changes for NSAIDs.
  • To address the limitations in current NSAID research concerning the elderly.
  • To emphasize the need for studies considering unbound drug fractions, enantiomers, and metabolites.

Main Methods:

  • Review of existing literature on NSAID pharmacokinetics and pharmacodynamics in the elderly.
  • Analysis of factors influencing NSAID disposition, including protein binding, chirality, and acylglucuronide formation.
  • Identification of gaps in current research methodologies.

Main Results:

  • Many studies report only total NSAID levels, neglecting the active unbound fraction.
  • Chiral NSAIDs require assessment of the active S-enantiomer's disposition.
  • Acylglucuronide metabolites can revert to active drug, with potentially reduced renal elimination in the elderly.

Conclusions:

  • Future NSAID studies in the elderly must quantify unbound drug fractions.
  • Assessment of the active S-enantiomer is critical for chiral NSAIDs.
  • Accounting for acylglucuronide reversion and renal elimination is necessary for accurate NSAID safety and efficacy evaluation in older adults.

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