Pharmacological issues in the elderly

This chapter presents a case of 79-year-old man who presented with increasing confusion, general weakness, and lethargy. There are multiple intrinsic and extrinsic factors that contribute to the risk of adverse drug reactions in the elderly population. Older adults have significant alterations in pharmacokinetics and pharmacodynamics that influence the way they process and respond to medications. The aging process is associated with increased chronic diseases that require treatment with multiple medications often resulting in polypharmacy. The physiologic changes and the increased number of medications increase the risk of adverse drug reactions and drug-drug interactions in this population. Pharmacodynamics relates the effect of a drug on the end organ or the physiologic effect of the drug. The brown bag checkup is the less formal but effective process of going through the patient's bag of medications at the bedside with the patient and family or caregiver.