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Drug mechanisms in the elderly 

Drug mechanisms in the elderly
Chapter:
Drug mechanisms in the elderly
Author(s):

Ipek Yalcin Christmann

and Oya Yalcin Cok

DOI:
10.1093/med/9780199604999.003.0003
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date: 20 August 2019

The majority of therapeutic options in the elderly rely on drug administration; yet, an understanding of the changes in drug mechanisms with ageing and associated drug interactions is too often lacking. This chapter describes the age-related changes in both pharmacodynamics and pharmacokinetics. It then reviews the impact these changes have on the clinical use of anaesthetic and analgesic drugs, including volatile and intravenous anaesthetic agents, neuromuscular blocking agents, and local anaesthetics. This is summarized in a very useful table for quick reference. There follows a description of the variation in both kinetics and dynamics across the range of analgesics used in anaesthesia, which means that some require much more careful titration, remifentanil, for instance, than others.

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