Preclinical Laboratory for Drug Delivery Innovations, College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada.
School of Biomedical Engineering, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
J Drug Target. 2024 Dec;32(10):1186-1206. doi: 10.1080/1061186X.2024.2386626. Epub 2024 Aug 9.
The geriatric population encompasses the largest part of the health care system worldwide. Chronic medical conditions are highly prevalent in the elderly, consequently, due to their complex health needs, there is a significant rate of multi-drug therapy. Despite the high numbers of medications prescribed, geriatric patients face several barriers when it comes to successful drug delivery including alterations in cognitive and physical function. The current review highlights the impact of chronic diseases on the ageing population along with how changes in drug pharmacokinetics could impact drug efficacy and safety. Also discussed are applications of administration routes in the geriatric population and complications that could arise. A focus is placed on the traditional and upcoming drug delivery advancements being employed in seniors with a focus addressing obstacles faced by this patient category. Nanomedicines, three-dimensional printing, long-acting formulations, transdermal systems, orally disintegrating tablets, and shape/taste modification technologies are discussed. Several barriers to drug delivery in the elderly have been identified in literature and directions for future studies should focus on addressing these gaps for geriatric drug formulation development including personalised medicine, insights into novel drug delivery systems like nanomedicines, methods for decreasing pill burden and shape/size modifications.ARTICLE HIGHLIGHTSTypically, senior citizens take more medications than any other patient population, yet most drug delivery technologies are not tailored to address the specific cognitive and physical barriers that these individuals encounter.The safety of drug delivery systems in the elderly patients should be prioritised with considerations on changes in pharmacokinetics with age, use of non-toxic excipients, and selecting drugs with minimal off-target side effects.Several commercialised and upcoming drug delivery technologies have begun to address the current limitations that the ageing population faces.Future research should focus on applying novel strategies like 3D printing, personalised medicine, and long-acting formulations to improve drug delivery to elderly patients.
老年人群体在全球医疗保健系统中占据最大部分。慢性疾病在老年人中非常普遍，因此，由于他们复杂的健康需求，存在着很高的多药物治疗率。尽管开出的药物数量很多，但老年患者在成功进行药物输送方面面临着几个障碍，包括认知和身体功能的改变。本综述重点介绍了慢性疾病对老年人口的影响，以及药物药代动力学的变化如何影响药物的疗效和安全性。还讨论了在老年人群体中给药途径的应用以及可能出现的并发症。重点关注传统和即将推出的药物输送技术在老年人中的应用，以及针对这一患者群体所面临的障碍。讨论了纳米医学、3D 打印、长效制剂、透皮系统、口服崩解片和形状/口感修饰技术。文献中已经确定了老年人药物输送的几个障碍，未来的研究方向应该集中在解决这些老年人药物制剂开发的差距，包括个性化医学、对新型药物输送系统如纳米医学的深入了解、减少药丸负担的方法和形状/尺寸修饰。文章亮点通常，老年患者比任何其他患者群体服用更多的药物，但大多数药物输送技术并没有针对这些患者遇到的特定认知和身体障碍进行调整。应优先考虑老年患者药物输送系统的安全性，考虑到随着年龄的增长而改变药代动力学、使用无毒赋形剂以及选择具有最小非靶副作用的药物。几种商业化和即将推出的药物输送技术已经开始解决老年人口面临的当前限制。未来的研究应集中于应用新型策略，如 3D 打印、个性化医学和长效制剂，以改善老年患者的药物输送。
