The current state of knowledge on age, sex, and their interactions on clinical pharmacology.
Pharmacokinetic and pharmacodynamic changes occur with increasing age. Sex differences in pharmacokinetics and pharmacodynamics exist and persist at older age. The issue for the clinician is how to best treat the older patient with currently available knowledge. This communication highlights age- and sex-related differences in pharmacokinetics that should influence clinical practice and prescribing guidelines to optimize clinical responses. The most compelling data for sex-specific medication dosing guidelines for older patients are related to volume of distribution differences, or size differences, between the sexes and to differences in glomerular filtration rates.
Schwartz
J B
JB
Jewish Home of San Francisco, University of California San Francisco, San Francisco, California, USA. jschwartzmd@jhsf.org
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism*; D001682:Biological Availability; D001835:Body Weight; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D005260:Female; D005919:Glomerular Filtration Rate; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism; D007668:Kidney / Q000378:metabolism; D007674:Kidney Diseases / Q000378:metabolism; D008099:Liver / Q000201:enzymology; D008297:Male; D008657:Metabolic Clearance Rate; D004364:Pharmaceutical Preparations / Q000008:administration & dosage / Q000378:metabolism*; D010599:Pharmacokinetics; D010601:Pharmacology, Clinical; D019338:Polypharmacy; D017410:Practice Guidelines as Topic; D012737:Sex Factors; D014018:Tissue Distribution; D014481:United States
D007527:Isoenzymes; D004364:Pharmaceutical Preparations; D003577:Cytochrome P-450 Enzyme System