Aging is characterized by progressive impairment of functional capacities of all system organs, reduction in homeostaticmechanisms, and altered response to receptor stimulation. These age-related physiologic changes influence both pharmacokinetics andpharmacodynamics of drugs in elderly patients. Pharmacokinetic and pharmacodynamics changes as well as polypharmacy and comorbiditiesmay alter significantly the effect of pharmacological treatment with advancing age. With the same drug concentration at thesite of action, significant differences in the response to several drugs have been observed in older patients as compared to younger patients.Elderly patients are particularly suceptibles to the effects of frequently prescribed drugs acting on central nervous system, such asbenzodiazepines, antidepressants, antipsychotics and lithium, with high potential for adverse drug reactions. Moreover, in older patientsincreased sensitivity to warfarin resulting in increased risk of bleeding has been previously documented. On the other hand, reduced effectivenessof conventional doses of cardiovascular drugs, such as diuretics and -blockers, has been observed. Due to pharmacodynamicchanges, therefore, dose adjustment of the above mentioned cardiovascular and psychotropic drugs is recommended in elderly. Cliniciansshould be aware of the age-related physiologic changes affecting several organ systems and their implications on the effect of drugs thatare commonly prescribed to elderly patients.This review focuses on the main age-related pharmacodynamics changes of drugs acting on central nervous system and cardiovascularsystem, which are the most frequently prescribed medications in older patients.
Age-related changes in pharmacodynamics: focus on drug acting on cetral nervous and cardiovascular systems
Trifirò G
;
2011-01-01
Abstract
Aging is characterized by progressive impairment of functional capacities of all system organs, reduction in homeostaticmechanisms, and altered response to receptor stimulation. These age-related physiologic changes influence both pharmacokinetics andpharmacodynamics of drugs in elderly patients. Pharmacokinetic and pharmacodynamics changes as well as polypharmacy and comorbiditiesmay alter significantly the effect of pharmacological treatment with advancing age. With the same drug concentration at thesite of action, significant differences in the response to several drugs have been observed in older patients as compared to younger patients.Elderly patients are particularly suceptibles to the effects of frequently prescribed drugs acting on central nervous system, such asbenzodiazepines, antidepressants, antipsychotics and lithium, with high potential for adverse drug reactions. Moreover, in older patientsincreased sensitivity to warfarin resulting in increased risk of bleeding has been previously documented. On the other hand, reduced effectivenessof conventional doses of cardiovascular drugs, such as diuretics and -blockers, has been observed. Due to pharmacodynamicchanges, therefore, dose adjustment of the above mentioned cardiovascular and psychotropic drugs is recommended in elderly. Cliniciansshould be aware of the age-related physiologic changes affecting several organ systems and their implications on the effect of drugs thatare commonly prescribed to elderly patients.This review focuses on the main age-related pharmacodynamics changes of drugs acting on central nervous system and cardiovascularsystem, which are the most frequently prescribed medications in older patients.
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