Höffler D
Z Gerontol. 1981 Sep-Oct;14(5):382-7.
Liberation and absorption of drugs may be changed in elderly people. The distribution of water-soluble substances take place in a smaller, of fatty-soluble substances in a greater volume. According to the smaller GFR in elderly, the halflife-time of renally excreted drugs is prolonged. The pharmacokinetic changes in elderly are therefore multiple, and can hardly be predicted in the individual case. It seems important to use drugs with e white instead of a small therapeutic range (e. g. Penicillins, not Aminoglycosides). In some drugs (as diuretics, antihypertensives et al.) the effect and the side effects can judged clinically. In this drugs a strong clinically supervision of the patient is needed. Special attention in elderly patients should ly on the problem of compliance. In some special cases it is necessary to determine the plasma level.
老年人药物的释放和吸收可能会发生变化。水溶性物质的分布容积较小，脂溶性物质的分布容积较大。由于老年人肾小球滤过率较低，经肾排泄药物的半衰期会延长。因此，老年人的药代动力学变化是多方面的，在个体情况下很难预测。使用治疗窗宽而不是窄的药物（如青霉素，而非氨基糖苷类药物）似乎很重要。对于某些药物（如利尿剂、抗高血压药等），其疗效和副作用可通过临床判断。对于这类药物，需要对患者进行严格的临床监测。老年患者应特别注意依从性问题。在某些特殊情况下，有必要测定血药浓度。
