Practical pharmacology for older patients: avoiding adverse drug effects

Older patients experience adverse drug events more frequently than do younger adults, and they experience them in unexpected ways. The heterogeneity of the geriatric population leaves the investigator with a great deal of uncertainty and the clinician with little reliable guidance based on clinical investigations. Although few generalizations can be made, it is safe to say that at least a subgroup of patients exhibit one or more physiologic or pathologic alterations that can lead to unanticipated drug response. It is essential for the prescribing clinician to be mindful of the vulnerability of this population. Prescribing should be judicious and, in general, conservative, with an eye on the patient's specific vulnerabilities.