DRUG PRESCRIBING FOR ELDERLY PATIENTS

Objective: To describe the pharmacokinetic and pharmacodynamic changes that occur with aging and to discuss common problems noted with the u se of medications often prescribed for elderly patients. Design: We se arched the medical literature, reviewed pertinent articles, and summar ized drug-related information applicable to geriatric patients. Result s: Use of medications is common in the elderly population; most elderl y persons take two or more different medications each day. Aging is as sociated with anatomic and physiologic changes that can have an effect on how medications are handled. Such changes include alterations in v arious volumes of drug distribution and in drug absorption, metabolism , and clearance. Elderly patients may also have increased or decreased drug effects because of alteration in receptor response. These change s in pharmacokinetics and pharmacodynamics may result in a prolonged d rug half-life, an increased potential for drug toxicity, and a greater likelihood for adverse drug reactions. Conclusion: Medications for el derly patients should be prescribed only after the anatomic and physio logic changes of aging are understood and with increased surveillance for potential drug toxicity or adverse drug reactions.