Abstract
The body's handling of drugs can be significantly altered with age. An overview of the way the body manages the movement of drugs through the body, pharmacokinetics, and their interaction with the body to cause their effects, pharmacodynamics, is provided. Clinically significant changes rather than those seen only in laboratory-controlled conditions are stressed. Some specific drug categories that present increased risk for older patients (psychoactive drugs, non-steroidal anti-inflammatory drugs, histamine-2 antagonists and warfarin) are reviewed in detail. In summary, there are numerous changes in drug pharmacokinetics and pharmacodynamics with aging. Some of these can be clinically significant, causing adverse effects or lack of clinical efficacy. Knowledge of the mechanisms, and specific drugs at-risk, will enable practitioners successfully to prescribe drugs even from the high-risk categories.
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M. S. McDonagh
Joyce Laing works in the Department of Child and Family Psychiatry, Playfield House, Cupar, Fife, and is a Consultant Art Therapist to Psychiatric Hospitals and Prisons and Chairwoman of the Scottish Society of Art and Psychology.