Geriatric pharmacology; geropharmacology study of how medications affect older adults

Описание: Why Geriatric Pharmacology Matters
Polypharmacy: Nearly 90% of older adults take at least one prescription drug, and over one-third take five or more regularly. This increases the risk of drug interactions and adverse effects.

Age-related changes: Aging alters both pharmacokinetics (how the body handles drugs) and pharmacodynamics (how drugs affect the body).

Suboptimal prescribing: Up to 45% of patients aged 70–79 experience inappropriate or risky prescriptions, leading to preventable complications.

Pharmacokinetic Changes in Aging
Absorption: Usually unchanged, but slower gastric emptying may delay onset.

Distribution: Increased fat → longer half-life for lipophilic drugs (e.g., benzodiazepines); decreased total body water → higher plasma concentration of hydrophilic drugs.

Metabolism: Reduced liver mass and blood flow → slower clearance of drugs metabolized by the liver.

Excretion: Decline in renal function → accumulation of renally cleared drugs (e.g., aminoglycosides, digoxin).

Pharmacodynamic Changes
Increased sensitivity to CNS depressants (benzodiazepines, opioids).

Decreased responsiveness to β-adrenergic agonists (e.g., albuterol).

Altered homeostatic mechanisms → higher risk of hypotension, confusion, falls.

Common Challenges
Polypharmacy → drug-drug interactions, adverse drug reactions.

Adherence issues → cognitive decline, complex regimens, cost barriers.

Comorbidities → multiple diseases complicate prescribing.

Adverse effects → more frequent and severe in older adults.

Principles of Safe Prescribing in Older Adults
Start low, go slow: Begin with lower doses and titrate carefully.

Simplify regimens: Reduce pill burden and dosing frequency.

Avoid high-risk drugs: Use Beers Criteria as a guide (e.g., avoid long-acting benzodiazepines, anticholinergics).

Monitor closely: Regularly check renal and hepatic function, review medications.



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