Andres Tate M, McGrane Tracy, McEvoy Matthew D, Allen Brian F S
Department of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center Drive, 4648 TVC, Nashville, TN, USA.
Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center Drive, 4648 TVC, Nashville, TN 37232, USA.
Anesthesiol Clin. 2019 Sep;37(3):475-492. doi: 10.1016/j.anclin.2019.04.007. Epub 2019 Jun 19.
An aging worldwide population demands that anesthesiologists consider geriatrics a unique subset of patients requiring customization of practice. This article reviews the current literature investigating physiologic changes of the elderly that affect pharmacokinetics and pharmacodynamics. Changes in drug absorption, distribution, metabolism, and excretion are discussed as well as the ultimate effects of medications. Implications for practice regarding specific anesthetic and analgesic drugs are addressed. Despite the immense body of research that contributes to understanding of geriatric pharmacology, elderly patients often are excluded from rigorous research trials, and further scientific investigation to inform best practices for this group of patients is needed.
全球人口老龄化要求麻醉医生将老年医学视为一类需要实践定制的独特患者群体。本文回顾了当前研究老年人影响药代动力学和药效学的生理变化的文献。讨论了药物吸收、分布、代谢和排泄的变化以及药物的最终作用。阐述了特定麻醉药和镇痛药在实践中的意义。尽管有大量研究有助于理解老年药理学，但老年患者往往被排除在严格的研究试验之外，因此需要进一步的科学研究以为这组患者提供最佳实践依据。
