McAllister R G
Am J Cardiol. 1986 Feb 12;57(5):59C-62C. doi: 10.1016/0002-9149(86)91028-3.
Persons older than 65 years constitute 10% of the U.S. population but require approximately one-third of its health care service. A significant proportion of their disease states is related to adverse reactions to prescribed drugs. The origins of this disturbingly high incidence of untoward consequences from drug therapy are multiple and complex. They include: (1) alterations in expected patterns of drug handling associated with physiologic changes of the aging process itself, (2) alterations in responsiveness to specific types of drugs and (3) frequent occurrence of chronic and acute diseases. The data documenting pharmacokinetic changes in aging subjects are rudimentary, and the physician is commonly aware only of pharmacokinetic profiles derived from studies in healthy, young subjects. Without a firm basis on which to rest pharmacologic therapy, the clinical approach to drug treatment in the elderly patient must be cautious and conservative.
65岁以上的人群占美国人口的10%，但却需要约三分之一的医疗保健服务。他们相当一部分疾病状态与处方药的不良反应有关。药物治疗产生这种令人不安的高不良后果发生率的原因是多方面且复杂的。这些原因包括：（1）与衰老过程本身的生理变化相关的药物处理预期模式的改变；（2）对特定类型药物反应性的改变；以及（3）慢性和急性疾病的频繁发生。记录老年受试者药代动力学变化的数据尚不完善，医生通常只了解来自健康年轻受试者研究的药代动力学特征。由于缺乏药物治疗的坚实基础，老年患者药物治疗的临床方法必须谨慎和保守。
