Altered Pharmacodynamics of Cardiovascular Drugs and Their Relation to Altered Pharmacokinetics in Elderly Patients

Abernethy, Darrell R.

doi:10.1016/s0749-0690(18)30617-7

Cited by 17 publications

(6 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…End‐organ response is affected by physiological changes that occur with increasing age in the absence of pathology. Of particular interest to pharmacologists are the age‐related changes in calcium channels and beta‐adrenergic receptors, with implications for the clinical use of their agonists and antagonists [1]. For example, the beta‐adrenergic response decreases with increasing age, and controlling for plasma concentration, the bradycardic response to labetolol is decreased in older people [129].…”

Section: Age‐related Changes In Pharmacodynamicsmentioning

confidence: 99%

“…The demand for expertise in clinical pharmacology and geriatric medicine grew exponentially at the end of the last century, reflecting the dramatic increase in medication usage and the ageing population. The interplay between these specialties is critical for modern prescribing because older people are the major users of medications and their responses to medications are highly variable [1,2].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Clinical pharmacology in the geriatric patient

Hilmer

McLachlan

Couteur

2007

Fundamemntal Clinical Pharma

247

193

View full text Add to dashboard Cite

Geriatric patients are a subset of older people with multiple comorbidities that usually have significant functional implications. Geriatric patients have impaired homeostasis and wide inter‐individual variability. Comprehensive geriatric assessment captures the complexity of the problems that characterize frail older patients and can be used to guide management, including prescribing. Prescribing for geriatric patients requires an understanding of the efficacy of the medication in frail older people, assessment of the risk of adverse drug events, discussion of the harm:benefit ratio with the patient, a decision about the dose regime and careful monitoring of the patient's response. This requires evaluation of evidence from clinical trials, application of the evidence to frail older people through an understanding of changes in pharmacokinetics and pharmacodynamics, and attention to medication management issues. Given that most disease occurs in older people, and that older people are the major recipients of drug therapy in the Western world, increased research and a better evidence base is essential to guide clinicians who manage geriatric patients.

show abstract

Section: Age‐related Changes In Pharmacodynamicsmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical pharmacology in the geriatric patient

Hilmer

McLachlan

Couteur

2007

Fundamemntal Clinical Pharma

247

193

View full text Add to dashboard Cite

show abstract

“…There are physiological changes in the kidneys, liver, and cardiovascular organs. These changes may lead to changes in the pharmacokinetics, i.e., the bioavailability, distribution, and elimination, as well as the pharmacodynamic effects, of the CV drugs, 8,9 which can mean that appropriate doses and dosing intervals are different from those in younger adults. If these factors are not considered, the result may be a greater or lesser effect than intended; significant mortality may also result, e.g., from inappropriate use of digoxin 10 .…”

mentioning

confidence: 99%

Use of Cardiovascular Drugs in an Older Swedish Population

Wills

Fastbom

Claesson³

et al. 1996

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

“…Not only is there a diminished response by the β-adrenoreceptor, but also the number of receptors is downregulated [16,17] In the CNS, the number of dopaminergic and cholinergic neurons and dopamine D and cholinergic receptors are reduced. For example, in the cardiovascular system, the aged myocardium has a lower sensitivity to catecholamines.…”

Section: Pharmacodynamicsmentioning

confidence: 99%