Elderly Americans make up 11 percent of the population but consume 25 percent of all prescription medications. The incidence of adverse drug effect is 1.5 to 3 times higher in older patients and accounts for numerous hospitalizations. The basic pharmacokinetic parameters of absorption, distribution, metabolism, and excretion are all significantly altered in geriatric patients. Certain specific drug side effects, such as orthostatic hypotension and anticholinergic effects, can be particularly hazardous in older patients. This paper describes general therapeutic principles for geriatric patients. Commonly used drug categories are considered separately. A thorough knowledge of these principles will allow the physician to prescribe drugs more effectively, improve patient compliance, and minimize adverse drug effects.
美国老年人占总人口的11%，却消耗了所有处方药的25%。老年患者药物不良反应的发生率比年轻患者高1.5至3倍，且导致大量住院病例。老年患者在吸收、分布、代谢和排泄这些基本药代动力学参数方面均有显著改变。某些特定的药物副作用，如体位性低血压和抗胆碱能效应，在老年患者中可能尤其危险。本文介绍了老年患者的一般治疗原则。常用药物类别将分别予以考虑。深入了解这些原则将使医生能够更有效地开药，提高患者的依从性，并将药物不良反应降至最低。
