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Hepatic drug metabolism and aging
C Durnas1, C M Loi, B J Cusack
1Clinical Pharmacology and Gerontology Research Unit, Veterans Affairs Medical Center, Boise, Idaho.
Clinical Pharmacokinetics
|November 1, 1990
Summary
Drug metabolism is often impaired in older adults due to physiological changes. Initial reduced drug doses are recommended for the elderly, adjusted based on clinical response and other factors.
Area of Science:
- Pharmacology
- Geriatrics
- Drug Metabolism
Background:
- Age-related physiological changes can impair drug metabolism in the elderly.
- Reduced liver mass, enzyme activity, and blood flow contribute to decreased drug elimination.
- Distinguishing aging effects from other factors like genetics and disease is challenging.
Purpose of the Study:
- To review the impact of aging on drug biotransformation.
- To discuss age-related physiological changes affecting drug metabolism.
- To provide guidance on drug dosing in older populations.
Main Methods:
- Literature review of studies on aging and drug metabolism.
- Analysis of factors influencing drug elimination in the elderly.
- Discussion of cytochrome P450 isozymes and drug interactions.
Main Results:
- Drug metabolism is frequently impaired in the elderly.
- Reduced initial doses of metabolized drugs are advisable for older patients.
- Elderly individuals show similar responses to enzyme inducers/inhibitors as younger patients.
Conclusions:
- Dosing adjustments for the elderly should consider clinical response and concurrent medications.
- Further research is needed on age-specific effects on drug metabolism pathways and phenotypes.