Physiologic changes that occur in the elderly

What are the physiologic changes that occur in the elderly?

GeneralIncreased body fat
Decreased total body water
Decreased muscle mass
Increased for lipophilic drugs
Decreased for hydrophilic drugs
Delayed onset of action
Prolonged half life
Increased plasma levels
Higher frequency of ASEs
CardiovascularDecreased cardiac indexRapid and high drug peakIncreased toxicity risk
GastrointestinalAltered secretions
Decreased gastric emptying
Decreased gastric acid secretion
Decreased splanchnic blood flow
Decreased absorptive capacity
Increased transit time
Decreased drug absorption
Altered oral bioavailability
LiverDecreased liver blood flow
Decreased liver mass
Decreased protein synthesis
Decreased hepatic enzyme function
Decreased serum albumin
Decreased first pass metabolism
Decreased liver clearance
Increased bioavailability of drugs with extensive first pass metabolism
Decreased bioavailability of prodrugs requiring activation by liver
Increased toxicity risk
Decreased clearance of high extraction ratio drugs
RenalDecreased GFR
Decreased renal blood flow
Decreased size
Decreased renal clearanceDose adjustment
Nervous systemDecreased cerebral blood flow
Decreased neurotransmitters
Neuronal atrophy
Altered receptor density/affinity
Decreased descending inhibitory pain control
Altered pain processing
Altered response to pain
Increased pain with noxious stimuli
Altered response to CNS/PNS drugs

ASEs , Adverse side effects CNS , central nervous system; GFR , glomerular filtration rate; PNS , peripheral nervous system; , volume of distribution.Rastogi R, Meek BD. Management of chronic pain in elderly, frail patients: finding a suitable, personalized method of control. Clin Interv Aging . 2013:37, Web.


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