[Peculiarities of drug therapy in the elderly]

Old people (over 70) are often treated with drugs. With respect to the indications for drug treatment, pharmacokinetics and pharmacodynamics, as well as undesired adverse drug reactions, there are a number of points peculiar to old age.

The usefulness of so-called geriatric drugs in the treatment of age-associated disorders continues to be controversial. The proportionate reduction in fat-free body mass leads to a change in drug distribution volumes, which can have an influence on the half-life of the substances concerned. While the perfusion of the liver and kidneys diminishes, effects on drug metabolism tend to be due to disease rather than aging processes. In old age, the incidence of side effects of medication is increased-the main cause of this, however, being the greater number of medicaments taken simultaneously, and not age in itself. A generally passive attitude towards treatment of the old patient is, however, not justified.

In old age, too, the general rule applies: as few drugs as possible, but then used selectively. Therapeutic regimens should be regularly checked and the results of treatment critically evaluated; a specific search should be made for adverse reactions.