Reviews in Clinical Gerontology

Review Article

Individualization of drug therapy in older people

P Scibonaa1, F Angrimana1a3, C Vazqueza1, BL Ferreyroa1a3, AG Perelszteina3, VA Simonovicha1, JR Jaureguia2, CG Mussoa2 and WH Bellosoa1a3 c1

a1 Clinical Pharmacology Section, Internal Medicine Service, University of Buenos Aires School of Medicine, Argentina

a2 Ageing Biology Unit, Hospital Italiano de Buenos Aires, University of Buenos Aires School of Medicine, Argentina

a3 Department of Pharmacology, University of Buenos Aires School of Medicine, Argentina

Summary

Older people are high consumers of prescription drugs and are at increasing risk of polypharmacy and adverse reactions. Pharmacokinetic and pharmacodynamic modifications due to age and co-morbidities are an important consideration, but pharmacological background evidence to guide safe and effective therapeutic approaches are often inadequate since the older population is under-represented in clinical trials. We review the pharmacokinetic and pharmacodynamic changes that are characteristic in old age and consider evidence regarding potentially safer prescription and monitoring of drugs commonly used in older patients. We also introduce the possible role of pharmacogenomics and therapeutic drug monitoring as tools to guide the individualization of drug therapy.

Key words:

  • aged;
  • pharmacokinetics;
  • drug toxicity;
  • therapeutics;
  • drug monitoring;
  • pharmacogenomics

Correspondence

c1 Address for correspondence: Dr Waldo Horacio Belloso, Clinical Pharmacology Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Juan D. Perón 4190 (C1181ACH), Buenos Aires, Argentina Email: waldo.belloso@hospitalitaliano.org.ar