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Published in: Drugs & Aging 3/2006

01-03-2006 | Review Article

Drug Dosage in the Elderly

Dermatological Drugs

Authors: Dr Anna Flammiger, Howard Maibach

Published in: Drugs & Aging | Issue 3/2006

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Abstract

Drug pharmacokinetics and pharmacodynamics may be altered in the elderly. An important contribution is made by decreased renal function, but biotransformation in the liver may also play a role. Commonly prescribed dermatological drugs such as methotrexate and cetirizine are likely to be eliminated more slowly in the elderly and potentially hepatotoxic drugs such as itraconazole and acitretin should be used with caution. Altered drug distribution as a result of body composition changes can lead to prolonged half-life or higher plasma concentrations of many drugs. Higher prevalence of adverse drug reactions and multidrug regimens, and large interindividual variability in drug response make drug dosage and administration in the elderly challenging. New immunobiological agents such as alefacept, efalizumab and etanercept, which are approved for treatment of psoriasis, seem to be as well tolerated in the elderly as in younger patients. A recommended approach when prescribing drugs to the elderly would be to start with a small initial dose and to reduce the number of drugs administered simultaneously. It is crucial to simplify the drug regimen as much as possible in order to enhance drug management in the elderly. To improve pharmacotherapy in the elderly, we review age-related changes in pharmacokinetics that are likely to play a role in dermatological practice.
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Metadata
Title
Drug Dosage in the Elderly
Dermatological Drugs
Authors
Dr Anna Flammiger
Howard Maibach
Publication date
01-03-2006
Publisher
Springer International Publishing
Published in
Drugs & Aging / Issue 3/2006
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI
https://doi.org/10.2165/00002512-200623030-00003

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