What affects drug metabolism in elderly?
Aging results in a number of significant changes in the human liver including reductions in liver blood flow, size, drug-metabolizing enzyme content, and pseudocapillarization. Drug metabolism is also influenced by comorbid disease, frailty, concomitant medicines, and (epi)genetics.
How does drug metabolism change with age?
Generally, older age is associated with increased blood concentrations of drugs and altered metabolism, reduced effectiveness, and increased risk of adverse reactions for many medications (2). Therefore, age-related changes in drug metabolism and elimination have much broader implications for disease susceptibility.
What body changes in the elderly can affect pharmacokinetics of drugs?
Table 1
| Drug | Pharmacodynamic effect | Age-related change |
|---|---|---|
| Diphenhydramine | Postural sway | ↔ |
| Enalapril | ACE inhibition | ↔ |
| Furosemide | Peak diuretic response | ↓ |
| Heparin | Anticoagulant effect | ↔ |
Why are NSAIDs not recommended for elderly?
NSAID use increases the risk of GI bleeding in the elderly four folds [21]. The mechanism underlying NSAIDs induced GI adverse effects lies in the fact that these medications inhibit prostaglandin synthesis, causing weakening of the protective GI mucosal barrier, predisposing one to bleeding.
What factors can affect drug metabolism?
Physiological factors that can influence drug metabolism include age, individual variation (e.g., pharmacogenetics), enterohepatic circulation, nutrition, intestinal flora, or sex differences. In general, drugs are metabolized more slowly in fetal, neonatal and elderly humans and animals than in adults.
What causes the rate of absorption of a medication to be affected in the elderly?
In the elderly there is a reduction in gastric pH which, in the case of some drugs, affects the solubility and thus will influence the rate of absorption. Furthermore, there is a reduction in intestinal blood flow, which would tend to delay or reduce drug absorption.
What are the factors affecting drug metabolism?
Which organ is responsible for drug metabolism and must be considered when prescribing medication for an older adult?
The kidney is the main organ involved in drug excretion; therefore the pharmacokinetics of aging induced change mainly results from reduced kidney functionality. It is the most important factor in producing toxic drug reactions in the elderly.
What factors affect drug absorption metabolism and elimination?
There are four factors that will influence the pharmacokinetic drugs test: water-solubility; fat-soluble; dissociation degree and molecular weight. Pharmacokinetic is a quantitative study of drugs in the body absorption, distribution, metabolism and excretion of the law.
What is the safest Nsaid for elderly?
For most older adults, the safest oral OTC painkiller for daily or frequent use is acetaminophen (brand name Tylenol), provided you are careful to not exceed a total dose of 3,000mg per day. Acetaminophen is usually called paracetamol outside the U.S.
What are three things that can affect drug metabolism?
Why is drug metabolism a problem in the elderly?
It appears that the majority of deleterious clinical outcomes related to drug therapy in an elderly (usually ill or frail) population may be ascribed to various anatomical and physiological age-related changes. These may affect both pharmacodynamics and pharmacokinetics, but not necessarily drug metabolism.
Are there any inflammatory diseases in the elderly?
There is one medical term that is often used by both health care professionals and the general public yet it is not often fully understood by most people. The elderly, with their age-related complaints and chronic diseases that tend to start in the later years, will have heard of inflammation and inflammatory diseases over and over again.
How to deal with inflammation in the senior years?
Dealing with Inflammation in the Senior Years. There is no single way to counteract the inflammatory process when it arises. Remember that this process is the body’s natural mechanism to protect itself and limit damage. Medication known as anti-inflammatory drugs can help reduce inflammation for periods of time.
How is the bioavailability of drugs affected by age?
As the hepatic first-pass effect of highly cleared drugs could be reduced (due to decreases in liver mass and perfusion), the bioavailability of some drugs can be increased in the elderly. Significant changes in body composition occur with advancing age.