Download Aging and Drug Therapy by I. H. Stevenson (auth.), G. Barbagallo-Sangiorgi, A. N. PDF

By I. H. Stevenson (auth.), G. Barbagallo-Sangiorgi, A. N. Exton-Smith (eds.)

One of the best advances in Geriatric medication over the last zone of a century has been the elevated awareness of the probabilities of remedy for aged sufferers. overlook has been changed via a extra confident healing endeavour and numerous previous humans have benefitted from this procedure. yet there's additionally an obstacle, and this is often the chance of dangerous negative effects of drugs that are frequently without delay proportional to the organic efficiency of the drug and will be unpredictably elevated because of alterations within the senile organism. in reality the anatomical and organic adjustments in previous age regulate either the kinetics of so much medicines and the receptor reaction. as a result of those alterations the person tolerance of elderly sufferers to drug remedy could be really various from that of more youthful topics. hence for numerous purposes aged sufferers obtain extra medicines, yet they're at a better threat of encountering opposed reactions, which frequently convey unusual medical positive aspects. we will be able to for this reason communicate of "geriatric iatrogenic problems" and indicate that a few of these unwanted side effects are made up our minds via a fancy pathogenesis end result of the specific pathophysiological within the aged. you will need to motivate the behavior of individ­ ually comparing capability hazard as opposed to anticipated merits of substances according to a similar rules followed within the evaluate of cost/benefit ratio.

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N. , Plenum Press, New York and London (1980). N. J. 1:539 (1969). L. F. Jarvik, D. J. Greenblatt, D. l6), Raven Press, New York (1981). J. W. Smith, L. G. Seidl, L. E. Cluff, Studies on the epidemiology of adverse drug reactions. V. Clinical factors influencing susceptibility, Ann. Med. 65:629 (1966). R. E. Vestal, Drug use in the elderly: a review of problems and special considerations, Drugs 16:358 (1978). o. L. Wade, Drug therapy in the elderly, Age & Ageing 1:65 (1978) J. Williamson, Adverse reactions to prescribed drugs in the elderly, in: "Drugs and the Elderly," J.

PHYSIOLOGICAL FACTORS With aging, there are physiological changes that may alter pharmacokinetics as well as target organ sensitivity. These include: Changes in Absorption Reduced gastrointestinal blood flow, changes in pH and in motility, and reduced numbers of absorbing cells and intestinal 26 S. M. CHIERICHETTI surface area can affect the active transport system and alter the absorption rate of certain drugs. Moreover, we lack knowledge of the effect of bedrest (very usual in the elderly) on pharmacokinetics.

I am, however, able to give some hitherto unpublished data on the drugs being taken by This sample has been a random sample of old people in Edinburgh. 2 Table 1 summarises the findings and indicates the widespread use of drugs by the general elderly population. It will be seen that certain drugs are used significantly more frequently by females, especially analgesics, psychotropics and haematinics. It is also noteworthy that almost 3 per cent of females were receiving thyroxine replacement therapy.

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