Ouslander J G
Ann Intern Med. 1981 Dec;95(6):711-22. doi: 10.7326/0003-4819-95-6-711.
Age-related biologic and physiologic changes in the elderly may lead to altered pharmacokinetics. Volume of distribution, half-life, systemic clearance, and receptor sensitivity have been shown to change with increasing age. Unique features of illness in the elderly may interfere with effective drug therapy more than changed pharmacokinetics in some patients. Physical, psychologic, and socioeconomic considerations often interfere with ability to obtain and comply with health care. Disease is often difficult to recognize in elderly patients. Multiple chronic conditions, many of which may be undetected, may be exacerbated by or alter drug therapy for other illnesses. Cognitive impairment and diminished vision and hearing may make patient education difficult, and compliance poor. The elderly are also more susceptible to adverse drug reactions. The recommendations for clinical practice and directions for future research that are presented should help make drug therapy in the elderly safer and more effective.
老年人与年龄相关的生物学和生理学变化可能导致药代动力学改变。分布容积、半衰期、全身清除率和受体敏感性已被证明会随着年龄的增长而变化。在某些患者中，老年人疾病的独特特征可能比药代动力学改变更能干扰有效的药物治疗。身体、心理和社会经济因素常常会干扰获得和遵循医疗保健的能力。老年患者的疾病往往难以识别。多种慢性病（其中许多可能未被发现）可能会因其他疾病的药物治疗而加重或改变。认知障碍以及视力和听力下降可能使患者教育变得困难，依从性也较差。老年人也更容易发生药物不良反应。本文提出的临床实践建议和未来研究方向应有助于使老年人的药物治疗更安全、更有效。
