Prescribing in older people.
BACKGROUND
Prescribing medications to older people is difficult due to comorbidity, limited evidence for efficacy, increased risk of adverse drug reactions, polypharmacy, and altered pharmacokinetics.


OBJECTIVE
This article describes the principles underlying clinical geriatric pharmacology including approaches to evaluating the evidence for risk and benefit, and adjusting dose for age related pharmacokinetic changes.


CONCLUSIONS
The challenge for the general practitioner is to balance an incomplete evidence base for efficacy in frail, older people against the problems related to adverse drug reactions without denying older people potentially valuable pharmacotherapeutic interventions.
Le Couteur
David G
DG
Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales. dlecouteur@med.usyd.edu.au
Hilmer
Sarah N
SN
Glasgow
Nicholas
N
Naganathan
Vasi
V
Cumming
Robert G
RG
D000368:Aged; D000375:Aging / Q000378:metabolism*; D002986:Clinical Trials as Topic; D015897:Comorbidity; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions; D016330:Frail Elderly; D005853:Geriatrics; D006801:Humans; D008875:Middle Aged; D010599:Pharmacokinetics; D019338:Polypharmacy