Abstract
Drug and dose selection in older adults is a complex process. Ensuring an optimal regimen may involve considerations beyond those that are immediately obvious. Factors affecting dosing in older adults vary across a wide spectrum and include changes to pharmacokinetics, pharmacodynamics, cognitive abilities, financial constraints, functional deficits, varying treatment-specific endpoints, and availability of evidence-based medicine. This chapter reviews these concepts and outlines the thought processes that clinicians should consider while making their dosing decisions. Recommendations to address these issues often include a combination of interventions and may require some creativity on behalf of the family, caregiver, and health care professionals. These factors should be considered during product development and could result in improved care of older adults.
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References
Hughes GJ, Beizer JL. Appropriate prescribing. In: Ham RJ, Sloane PG, Warshaw GA, et al., editors. Ham’s primary care geriatrics: a case-based approach. 6th ed. Philadelphia: Elsevier; 2014. p. 67–76.
Carnahan RM, Lund BC, Perry PJ, et al. The anticholinergic drug scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol. 2006;46(12):1481–6.
Semla TP, Beizer JL, Higbee MD. Geriatric dosage handbook. 20th ed. Hudson, Ohio: Lexi-Comp, Inc.; 2014.
American Geriatrics Society 2015 Updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63:2227–46.
Delafuente JC. Pharmacokinetic and pharmacodynamic alterations in the geriatric patient. Consult Pharm. 2008;23(4):324–34.
Wedemeyer R-S, Blume H. Pharmacokinetic drug interaction profiles of proton pump inhibitors: an update. Drug Saf. 2014;37:201–11.
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© 2016 American Association of Pharmaceutical Scientists
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Hughes, G.J., Beizer, J.L. (2016). Dosing Considerations in Older Adults. In: Stegemann, S. (eds) Developing Drug Products in an Aging Society. AAPS Advances in the Pharmaceutical Sciences Series, vol 26. Springer, Cham. https://doi.org/10.1007/978-3-319-43099-7_14
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DOI: https://doi.org/10.1007/978-3-319-43099-7_14
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