Chapter 30. Altered Drug Action in the Elderly

Lamy, Peter P.; Lesko, Lawrence J.

doi:10.1016/s0065-7743(08)61056-8

Cited by 3 publications

(2 citation statements)

References 106 publications

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“…Multiple Disorders and Severity of Disease Pathological conditions can alter drug disposition by increasing steady state concentration or prolonging half‐life 52 . Thus, severe morbidity may influence patient susceptibility to adverse drug reactions.…”

Section: Factors Which Influence Patient Susceptibility To Adverse Drmentioning

confidence: 99%

Prescribing for the Elderly Part I: Sensitivity of the Elderly to Adverse Drug Reactions*

Nolan

O’Malley

1988

J American Geriatrics Society

300

107

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Section: Factors Which Influence Patient Susceptibility To Adverse Drmentioning

confidence: 99%

Prescribing for the Elderly Part I: Sensitivity of the Elderly to Adverse Drug Reactions*

Nolan

O’Malley

1988

J American Geriatrics Society

300

107

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“…Indeed, persons 65 years of age and over face twice the risk of iatrogenic disease than do younger persons (Jahningen et al 1982), perhaps because of age-related alterations in drug action (Lamy 1991;Lamy & Lesko 1985), perhaps because of unrecognised undernutrition which may alter drug action, or perhaps be- (Braun 1991). This may not be at all surprising, since data on the treatment of older adults with hypertension, for example, have only recently been published.…”

Section: Drug Use In Elderly Patients: the Outcomementioning

confidence: 99%

Institutionalisation and Drug Use in Older Adults in the US

Lamy

1993

Drugs & Aging

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Since the introduction of Medicaid and Medicare in the US in 1965, the rate of use of nursing homes by elderly persons has more than doubled. Nursing home care accounts for about 8% of the healthcare budget. The rate of nursing home use by elderly people and the subsequent costs are expected to increase during the 1990s. The elderly nursing home population have a disproportionately high rate of drug consumption; it has been estimated that up to one-third of elderly nursing home residents receive 8 to 12 drugs per day. Multiple drug use is a risk factor for morbidity in elderly patients. Recent regulations have tried to rationalise the use of particular classes of drugs in nursing homes, with some success. However, multiple drug use is not necessarily unjustified, given the complex comorbidity seen in some patients. Since the value of many drugs has not been proven in the elderly population, further studies are required to prove the value of drugs used in this patient population in improving function and quality of life. Regular review of total regimens should be undertaken often.

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Medication Management

Lamy

Michocki

1988

Clinics in Geriatric Medicine

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The elderly receive more drugs than any other patient group, and those in nursing homes receive the most. However, little is known about drug action, particularly in the very old. A host of factors can alter drug action. Particular attention needs to be paid to the influence of intercurrent disease, other drugs in a particular regimen, the patient's weight and nutritional status, as well as altered pharmacokinetic and pharmacodynamic characteristics of any drug. Liver and kidney status, and changes therein, are most important.

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Chapter 30. Altered Drug Action in the Elderly

Cited by 3 publications

References 106 publications

Prescribing for the Elderly Part I: Sensitivity of the Elderly to Adverse Drug Reactions*

Prescribing for the Elderly Part I: Sensitivity of the Elderly to Adverse Drug Reactions*

Institutionalisation and Drug Use in Older Adults in the US

Medication Management

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