Rational pharmacotherapy for the elderly.

Aging is accompanied by normal physiologic changes. Paralleling these changes, disease further contributes to a decline in optimal organ-system function. Many of these changes produce significant alterations in pharmacodynamics and pharmacokinetics that are relevant to safe and effective pharmacotherapy in the elderly. As aging is accompanied by disease, chronic disease states lead to polypharmacy and drug-drug interactions. Drug therapy may cause further decline in organ-system functions, precipitate or exacerbate preexisting disease, and produce drug-induced illness. Consequently, pharamcotherapy in the elderly should only be instituted following comprehensive dentomedical assessment. Use as few drugs as possible. Prescribe the lowest therapeutic dose. Assess the patient's response frequently for compliance, drug effects, and toxicity. Discontinue unnecessary medications.