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[Changes in pharmacokinetics in the aged and their practical consequences]

D Höffler

    Zeitschrift Fur Gerontologie
    |September 1, 1981
    PubMed
    Summary

    Drug pharmacokinetics change significantly in elderly individuals, affecting absorption, distribution, and elimination. Careful drug selection and close clinical monitoring are crucial for safe and effective treatment in older adults.

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    Area of Science:

    • Geriatric Pharmacology
    • Drug Metabolism and Pharmacokinetics
    • Clinical Pharmacy

    Context:

    • Aging alters drug absorption, distribution, and elimination.
    • Reduced Glomerular Filtration Rate (GFR) in the elderly prolongs the half-life of renally excreted drugs.
    • Physiological changes in elderly individuals lead to complex and unpredictable pharmacokinetic variations.

    Purpose:

    • To highlight the pharmacokinetic alterations in the elderly population.
    • To emphasize the need for cautious drug selection and administration in geriatric patients.
    • To underscore the importance of clinical monitoring and patient compliance.

    Summary:

    • Drug liberation and absorption are altered in elderly individuals.
    • Distribution volumes differ for water-soluble and fat-soluble drugs.
    • Prolonged drug half-life due to decreased GFR necessitates careful dosing.
    • Prioritize drugs with a wide therapeutic range (e.g., Penicillins) over those with a narrow range (e.g., Aminoglycosides).
    • Clinical judgment is vital for drugs like diuretics and antihypertensives, requiring close patient supervision.
    • Patient compliance and, in select cases, plasma level monitoring are essential.

    Impact:

    • Informs healthcare providers about age-related pharmacokinetic changes.
    • Promotes safer and more effective medication management in the elderly.
    • Reduces the risk of adverse drug events and improves therapeutic outcomes in geriatric patients.

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