Gerontological Basis for Modifications in Drug Activity with Age

Bender, A. Douglas

doi:10.1002/jps.2600540835

Cited by 5 publications

(2 citation statements)

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“…The author is aware of the dangers of oversimplification. Other aspects such as the number of responsible cells, the lipoid/water partition coefficient of drugs, and the increased or decreased susceptibility to the effects of a drug (44–49) have not been covered in the scope of this paper. However, the number of drugs used in geriatric patients in multiple dosing, and with which there is danger of overdosing and hence severe side effects such as nephrotoxicity, is limited.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetic Approach to Drug Dosing in the Aged

Ritschel

1976

J American Geriatrics Society

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Data in the literature show that there is a constant ratio of total body fluid to lean cell mass with increasing age (1.15 for males and 1.31 for females). Since the drug receptors usually are found in the tissues, and since cell mass and total body fluid apparently decrease at a constant rate, it would seem that the volume of distribution of drugs decreases proportionally with increasing age. Kidney function, as measured by the glomerular filtration rate and transport maximum, apparently decreases with increasing age according to zero-order kinetics. Based on these data, correction factors were established for the change in volume of distribution and renal functions with increasing age. Equations were derived for calculating the loading dose and maintenance dosage of drugs in multiple-dose therapy in females and males. Equations are presented for drugs following the minimal inhibitory concentration (MIC) pattern and the log dose-response pattern, respectively. The MIC pattern is recommended in the use of bacteriostatic drugs, for which it is essential to maintain recommended in the use of bacteriostatic drugs, for which it is essential to maintain during the entire course of therapy a minimum inhibitory concentration. The log dose-response pattern is recommended for bactericidal and antiarrhythmia drugs, for which it is essential to obtain an average therapeutic steady-state concentration. Based on this pharmacokinetic approach, it would seem that elderly patients, during multiple-dose therapy, are exposed to dose sizes that are too large if no correction is made.

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetic Approach to Drug Dosing in the Aged

Ritschel

1976

J American Geriatrics Society

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“…This aspect concerns the effect of increasing age on the individual's mechanisms for handling drugs and the differences in drug activity which accompany various stages of the aging process (5)(6)(7). A number of reports ha,·e shown that drug activity is changed by increasing age.…”

Section: Effect Of Aging On the Actio~ Of Dr~gsmentioning

confidence: 99%