Specifika farmakoterapie ve stáří

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Title in English Specifics of pharmacotherapy in elderly
Authors

JUŘICA Jan

Year of publication 2020
Type Article in Periodical
Magazine / Source Remedia
MU Faculty or unit

Faculty of Medicine

Citation
Web http://www.remedia.cz/Archiv-rocniku/Rocnik-2020/3-2020/e-2T2-2WU.magissue.aspx?Page=2
Keywords pharmacotherapy; elderly; pharmacokinetics; pharmacodynamics; polypharmacy
Description The Czech population is ageing and the number of drugs used is growing with the age of patients. Along with physiological changes, which are logically reflected in the change of pharmacokinetics, the target sites of drug action (i.e. pharmacodynamics) often changes as well. Changes occur at the level of absorption, where peristalsis slows, the absorption area decreases, the pH in the stomach increases, and the gastric and intestinal mucosa is atrophic. In elderly, the composition of the human body changes and consequently the distribution of drugs changes as well. The elimination rate decreases in many drugs, not only due to the changes in the metabolic activity of cytochrome P450 enzymes. Elderly patients also have a reduced response to the drug on the one hand, while on the other hand (in more numerous group of drugs) there is an increased sensitivity to some of their effects. All these factors together contribute to the greater susceptibility of elderly to the adverse effects of drugs and drug related toxicity. This review article summarizes the most significant changes in pharmacokinetics and pharmacodynamics in elderly and provides examples of drugs that may be at risk for the elderly population.
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