1Why are older adults at higher risk for adverse effects?
high perscription drug use in the older adult population
2What is the goal of treatment?
reduce symptoms and improve quality of life
3Absorption
altered GI absorption is not a major factor in drug sensitvity
% of oral dose that is absorbed does not change with age
rate of absorption may slow with age
4Distribution
increased % of body fat-storage depot for lipid soluble drugs
decrease % of lean body mass
decrease total body water
reduced concentration of serum albumin
5Metabolism
Hepatic metabolism declines with age
reduced hepatic blood flow, reduced liver mass, and decreased hepatic enzymes
half life may increase
6Excretion **important**
renal function progressive decline
drug accumulation due to reduced renal excretion is most important cause of adverse drug reactions
7How should renal function be assessed? **important**
use creatinine clearance rather than serum creatinine to assess
8Adverse Drug Reactions (ADRs)
7 times more likely in the elderly
account for 16% of hospital admissions
50% of medication-related deaths
dizziness and cognitive impairment are most common
9What should you monitor to reduce ADRs? **important**
monitor the pt response and plasma drug levels