Pharmacokinetic and pharmacodynamic changes in the elderly. Clinical implications.
Age-related changes in pharmacokinetics principally affect drug absorption, distribution, metabolism and elimination. Changes in pharmacodynamics are primarily seen in the cardiovascular and neuroendocrine system. Age-dependent changes in the kinetics and dynamics of drugs acting on the cardiovascular system and central nervous system are common, and this review, while by no means exhaustive of the effects of drugs on all organ systems, is reflective of the principles and gives examples of the effects of age on these 2 major systems. While pharmacokinetic changes in the elderly are usually well characterised, pharmacodynamic changes are understood only in the most preliminary way. There has been relatively little research in this area of geriatric clinical pharmacology, and pharmacodynamic changes are still an area of investigation.
Department of Pharmaceutics, University of Florida, Gainesville, USA.
A
A
Hämmerlein
H
H
Derendorf
D T
DT
Lowenthal
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000493:pharmacokinetics; D000925:Anticoagulants / Q000493:pharmacokinetics; D001569:Benzodiazepines / Q000493:pharmacokinetics; D002121:Calcium Channel Blockers / Q000493:pharmacokinetics; D002320:Cardiovascular Physiological Phenomena / Q000187:drug effects; D002490:Central Nervous System / Q000187:drug effects / Q000502:physiology; D004077:Digoxin / Q000493:pharmacokinetics; D004358:Drug Therapy; D005919:Glomerular Filtration Rate; D006801:Humans; D008099:Liver / Q000378:metabolism; D010599:Pharmacokinetics
D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D002121:Calcium Channel Blockers; D001569:Benzodiazepines; D004077:Digoxin