References
Pharmacokinetics in older people: an overview of prescribing practice
Abstract
As the population ages, understanding the unique pharmacokinetic profiles of older adults is crucial for effective and safe medication management. This article provides an overview of the pharmacokinetic changes that occur with ageing, including alterations in absorption, distribution, metabolism, and excretion. Emphasising the implications for prescribing practice, the article highlights common challenges and strategies for optimising pharmacotherapy in older patients. By recognising the physiological changes and potential drug interactions, healthcare providers can tailor their prescribing practices to improve therapeutic outcomes and minimise adverse effects in this vulnerable population.
Understanding pharmacokinetics in older adults is crucial due to demographic trends showing a growing population of older individuals (Clifford et al, 2016; Reis da Silva, 2023a; 2023b). Older adults experience various pharmacokinetic and pharmacodynamic changes that affect how medications are absorbed, metabolised, and eliminated, leading to differences in drug response compared to younger adults (Pallesen et al, 2022). These alterations increase the risk of adverse drug reactions, especially in the context of managing conditions like sepsis that require precise drug therapy (Clifford et al, 2016).
The physiological and pathological changes associated with ageing, such as decreased physiological reserve and alterations in pharmacokinetic and pharmacodynamic factors, make older adults particularly vulnerable to medicine-related adverse effects (Yamada, 2023).
Polypharmacy, a common occurrence among older adults, further complicates the situation by increasing the risk of adverse drug events (Pallesen et al, 2022). The use of multiple medications to manage the multimorbidity often seen in older adults raises concerns about drug interactions and the potential for adverse outcomes (Dias et al, 2019). Additionally, older adults may exhibit altered pharmacokinetic and pharmacodynamic profiles, including reduced renal and hepatic clearance, increased volume of distribution of lipid-soluble drugs, and increased sensitivity to certain drug classes (Tayer-Shifman et al, 2021). These changes necessitate careful consideration when prescribing medications to older adults to ensure efficacy and safety.
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