Pharmacokinetics in the aged

  1. Domínguez-Gil, A.
  2. García, M.J.
  3. Navarro, A.S.
Libro:
Renal Function and Disease in the Elderly
  1. Juan F. Macias Nuñez (coord.)
  2. J. Stewart Cameron (coord.)

Editorial: Butterworth-Heinemann

ISBN: 9780407003958

Año de publicación: 1987

Páginas: 184-203

Tipo: Capítulo de Libro

DOI: 10.1016/B978-0-407-00395-8.50014-4 GOOGLE SCHOLAR lock_openAcceso abierto editor

Resumen

This chapter discusses the pharmacokinetics of drugs in the aged. The aim of pharmacokinetics research is to characterize the processes of absorption, distribution, metabolism, and excretion after the administration to the organism of substances with pharmacological activity. Whereas the first two processes determine the access of the drug to its site of action, metabolism and excretion contribute to the elimination of the drug from the organism. The dynamic equilibrium set up between these processes regulates the levels of drug in the organism and is frequently correlated with the intensity of the pharmacological effect. With advanced aged, the response to drugs is modified as a result of the changes taking place in the processes defining the disposition kinetics of drugs, of the changes in receptor sensitivity, and of the influence of associated pathological states. This is generally reflected in the requirement of lower doses in the elderly, compared with adult patients, and it is convenient to carefully monitor drug levels to individualize the doses administered. The application of pharmacokinetic criteria is of fundamental importance for establishing the correct dose of drugs in the elderly patient. This correction in the dosage regimen is particularly indicated when a decrease occurs in the plasma clearance of drugs with a low therapeutic index, thereby offering a high risk of intoxication by overdose. Among those drugs that are of special interest in this sense are digoxin, nitrofurantoin, aminoglycoside antibiotics, tricyclic antidepressants, etc.

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