Pharmacology of drugs in aging

Abstract

General principles for appropriate prescribing for the elderly are described in this chapter. Age-related changes in pharmacokinetics (absorption, distribution, metabolism, and distribution) with normal aging and in frail elderly patients are presented. Tools to identify potentially inappropriate medications in the elderly, including the American Geriatrics Society Beers Criteria and the STOPP/START criteria, are described. The prescription cascade, where a side effect of a medication is misinterpreted as a new medical condition leading to the introduction of another drug, is also described. The association between geriatric syndromes and medication use is presented as well as strategies to reduce fall risk-increasing medications. Assessment and review of medications in frail elderly patients should be done every 6 months.