Pharmacokinetics in old age

All practising clinicians will be aware of the increased number of elderly patients requiring drug treatment as the proportion of people over the age of 65 increases in our Western society. The elderly as a group have much to benefit from modern drug therapy, but, historically, are also the group most prone to adverse drug reactions. Such reactions have often been due to inappropriate drug prescribing based on an incomplete knowledge of changes in drug handling with age. In recent years there has been an increased understanding of the physiological changes of ageing and the changes in drug handling consequent upon these changes. This review will concentrate on the clinical sequelae of changes in drug handling and suggest areas where modification in prescribing practice may yield clinical benefits and lessen the toll of adverse drug reactions.