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Individualization of drug therapy in older people

Published online by Cambridge University Press:  20 March 2014

P Scibona ,
F Angriman ,
C Vazquez ,
BL Ferreyro ,
AG Perelsztein ,
VA Simonovich ,
JR Jauregui ,
CG Musso  and
WH Belloso
P Scibona
Affiliation:
Clinical Pharmacology Section, Internal Medicine Service, University of Buenos Aires School of Medicine, Argentina
F Angriman
Affiliation:
Clinical Pharmacology Section, Internal Medicine Service, University of Buenos Aires School of Medicine, Argentina Department of Pharmacology, University of Buenos Aires School of Medicine, Argentina
C Vazquez
Affiliation:
Clinical Pharmacology Section, Internal Medicine Service, University of Buenos Aires School of Medicine, Argentina
BL Ferreyro
Affiliation:
Clinical Pharmacology Section, Internal Medicine Service, University of Buenos Aires School of Medicine, Argentina Department of Pharmacology, University of Buenos Aires School of Medicine, Argentina
AG Perelsztein
Affiliation:
Department of Pharmacology, University of Buenos Aires School of Medicine, Argentina
VA Simonovich
Affiliation:
Clinical Pharmacology Section, Internal Medicine Service, University of Buenos Aires School of Medicine, Argentina
JR Jauregui
Affiliation:
Ageing Biology Unit, Hospital Italiano de Buenos Aires, University of Buenos Aires School of Medicine, Argentina
CG Musso
Affiliation:
Ageing Biology Unit, Hospital Italiano de Buenos Aires, University of Buenos Aires School of Medicine, Argentina
WH Belloso*
Affiliation:
Clinical Pharmacology Section, Internal Medicine Service, University of Buenos Aires School of Medicine, Argentina Department of Pharmacology, University of Buenos Aires School of Medicine, Argentina
*
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
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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.

Keywords

agedpharmacokineticsdrug toxicitytherapeuticsdrug monitoringpharmacogenomics
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 24 , Issue 2 , May 2014 , pp. 145 - 157
Copyright
Copyright © Cambridge University Press 2014 

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