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Age Changes

Age Changes. By Sue Henderson. Pharmacokinetics. How body acts on drug: Reduced renal function, resulting in reduced elimination of renally excreted drugs - toxicity Dosages should be reduced in the elderly (start low go slow) Acute illness can lead to rapid decrease in renal function.

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Age Changes

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  1. Age Changes By Sue Henderson

  2. Pharmacokinetics How body acts on drug: • Reduced renal function, resulting in reduced elimination of renally excreted drugs - toxicity • Dosages should be reduced in the elderly (start low go slow) • Acute illness can lead to rapid decrease in renal function

  3. Pharmacokinetics cont… • Water content of aging body decreases • Fat content increases

  4. Pharmaco-dynamics • How drugs act on the body • Changes in drug receptors/target organ responses - alter sensitivity to effect of drugs (> CNS effects of benzodiazepines). • Impairment of secondary compensatory mechanisms - predispose to adverse effects (orthostatic hypotension with diuretics or TCAs).

  5. Poly-pharmacy • Higher rates of disease in the elderly • Take many drugs • > interactions/adverse effects • Multiple sources (different doctors, hospitals, OTC, friends) • Hoarders of meds. • Medication review to confirm full list of drugs being taken

  6. Noncompliance • Unintentional - result confusion, forgetfulness • Intentional - to minimise adverse effects or save money.

  7. Minimising adverse effects • whenever possible, use non-pharmacological treatments • lowest feasible dose (often less than half usual adult dose) • smallest number of medications/simplest dose regimens • be familiar drug effects in elderly • liquid medications if difficulty in swallowing • Simple verbal/written instructions for every medication • presenting symptoms may be a result of medications (not old age) • child-proof containers (also elder proof) avoided • Regular review chronic - may be possible to stop medications or reduce dose if renal function declines • Make sure the carer understands treatment

  8. References Bochner, F., Rossi, S., Royal Australasian College of General Practitioners, Pharmaceutical Society of Australia, & Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists. (2008). Australian medicines handbook (8th ed.). Adelaide: Australian Medicines Handbook.

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