NURS 503 Lecture Notes - Lecture 5: Iatrogenesis, Akathisia, Movement Disorder
15 Oct 2018
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Reeve, e. ,wiese, m. d. , mangoni, a. a. (2015) alterations in drug disposition in older adults. Expert opinion on drug metabolism & toxicology, 11(4), 491-508, doi: Older adults are more susceptible to adverse drug reactions and other medication-related errors, a common cause of mortality and morbidity in this population. Drug-to-drug interactions and increased risk of polypharmacy. Distribution: amount of drug available to exert an effect at the active site: Dependent on tissue distribution and the extent of plasma and tissue protein binding: body composition: reduction in total body water, muscle mass and increase in body fat, plasma protein binding: albumin and alpha1-acid glycoprotein. There is an observed reduction in plasma albumin (due to increased elimination via the kidneys) Metabolism: results in conversion of an active drug into an inactive drug. (or vice versa for pro drug: hepatic blood flow and liver size are reduced with age. Elimination: may have poor renal function therefore: decreased elimination/excretion: gfr: cockcroft gault formula (using weight)
