Aging physiologic changes with

Some healthy elderly may not be very affected by pharmacological alterations whereas others have become very susceptible to adverse effects of drugs. It is especially important for elderly patients that pharmacotherapy is individualised. With knowledge of expected physiologic changes with aging, decisions should be based on the individual patient s disease and concomitant medications. 

There are many physiological changes with aging that make elderly more susceptible to drugs... 

Marked inter-patient variability exists in the pharmacokinetics of intravenous anaesthetics. Factors that can influence drug disposition include the degree of protein binding, the efficiency of the hepatic and renal clearance systems, physiological changes with ageing, disease states, site of operation, body temperature, and drug interactions (premedicants, volatile anaesthetics). 

There is a progressive functional decline in many organ systems with advancing age. Table 8-1 reviews some common physiologic changes with an emphasis on those which can affect pharmacotherapy. For more detailed information, readers are referred to excellent reviews. ... 

Amino acid levels in body fluids are influenced by a number of factors, such as age, physiological changes, nutritional status, illness and disease, medications and toxins. It is notable that medications can cause artifacts that interfere with the analysis or can disrupt the body s metabolism of amino acids, leading to an abnormal amino acid pattern which, although suggestive of an inborn error, is actually an acquired condition. These factors are discussed below. 

The prevalence of CHE increases and prognosis worsens with age. Some studies demonstrate that age markedly influences all follow-up events, including total mortality, and mortality or hospitalisation related to CHE. Some studies suggest that physiological changes occur in CHE with ageing with an age-related increase in systemic vascular resistance and circulating noradrenaline (norepinephrine) concentrations and a decrease in renal function. 

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