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Pharmacokinetics in the elderly

J Crooks, K O'Malley, I H Stevenson

    Clinical Pharmacokinetics
    |January 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

    Elderly individuals exhibit altered drug responses due to pharmacokinetic changes. This review examines age-related differences in drug absorption, metabolism, distribution, and excretion, highlighting areas needing further research in older adults.

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    Area of Science:

    • Pharmacology
    • Geriatrics
    • Drug Metabolism

    Background:

    • Elderly individuals often show different drug responses compared to younger populations.
    • Altered drug handling is a key factor, but the roles of pharmacokinetics and pharmacodynamics are not fully understood.
    • Existing data often relies on animal models or indirect human studies.

    Purpose of the Study:

    • To review and analyze available data on pharmacokinetics in the elderly.
    • To clarify age-related changes in drug absorption, metabolism, distribution, and excretion.
    • To identify knowledge gaps regarding drug response differences in older adults.

    Main Methods:

    • Review of existing literature on pharmacokinetic studies in elderly populations.
    • Analysis of data on drug absorption, metabolism (e.g., antipyrine), distribution (e.g., diazepam), and renal excretion (e.g., digoxin).

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  • Comparison of pharmacokinetic parameters between elderly and younger individuals.

    • Main Results:

    • Drug absorption via passive diffusion appears unchanged with age; active transport may be diminished.
    • Evidence suggests reduced drug metabolism in the elderly, though definitive data is limited for most drugs.
    • Changes in volume of distribution significantly impact drug clearance and concentration, with variable effects on drug action.

    Conclusions:

    • While some pharmacokinetic processes like renal excretion are clearly diminished in the elderly, generalizations about age-related drug metabolism and distribution are difficult.
    • Further research is needed to clarify the implications of altered pharmacokinetics on drug efficacy and safety in older adults.
    • Direct human studies are crucial to overcome limitations of animal models and indirect data.