Aging issues in drug disposition and efficacy.
The elderly represent a very rapidly increasing segment of human society worldwide. As people age, they accumulate multiple and chronic diseases that are very often managed with drug therapy. This approach to health maintenance is reflected by the fact that the elderly use a disproportionate amount of prescribed and over-the-counter medications compared to their numbers in the population. Cardiovascular diseases, almost always managed at least in part with drug therapy, remain a leading cause of morbidity and mortality in older individuals. Although we appreciate that there are physiological changes with aging to body composition, and renal, gastrointestinal, hepatic, and cardiovascular function that potentially confound optimization of drug therapy in the elderly, we have been slow to use this knowledge to improve pharmacological therapy of geriatric patients. This overview examines the physiological changes that commonly occur as we age, and focuses on the application of this knowledge to the potential for optimization of drug therapy of cardiovascular diseases of the elderly. Representative cardiovascular drugs are presented that are commonly used, and for which there is evidence of an opportunity to alter their use and potentially to improve therapy in this cohort.
Sitar
Daniel S
DS
Department of Pharmacology and Therapeutics, Faculty of Medicine, Department of Internal Medicine, Faculty of Medicine, Faculty of Pharmacy, Centre on Aging, University of Manitoba. sitar@cc.umanitoba.ca
D000375:Aging / Q000378:metabolism*; D000818:Animals; D001823:Body Composition / Q000502:physiology; D002318:Cardiovascular Diseases / Q000378:metabolism; D002320:Cardiovascular Physiological Phenomena; D004068:Digestive System Physiological Phenomena; D006801:Humans; D007668:Kidney / Q000502:physiology; D004364:Pharmaceutical Preparations / Q000378:metabolism*; D010599:Pharmacokinetics
D004364:Pharmaceutical Preparations