Key result
Age-related homeostatic changes alter drug responses, blunting beta-adrenergic and cholinergic effects in the elderly.
Why the study?
Response to drugs in the elderly may be altered by age-related changes in homeostatic mechanisms and receptor and target organ sensitivity, requiring further investigation.
How do age-related changes in homeostatic mechanisms and receptor sensitivity alter pharmacodynamic responses to drugs in the elderly?
How do age-related changes in homeostatic mechanisms and receptor sensitivity alter pharmacodynamic responses to drugs in the elderly?
Age-related changes in homeostatic mechanisms and receptor sensitivity, such as attenuated beta-adrenoceptor effects, significantly modify drug responses in the elderly.
Answers are grounded in this paper and cite their sources.
Requires cautious dosing and monitoring in elderly patients; extends pharmacodynamic evidence but leaves open prospective validation.
Response to drugs in the elderly may be accentuated or modified by age related changes in homeostatic mechanisms such as postural control, orthostatic circulatory responses, thermoregulation, visceral muscle function and higher cognitive function. Changes in specific receptor and target organ responses have also been described. beta-Adrenoceptor-mediated effects are apparently attenuated by a reduction in high affinity binding sites and altered post receptor mechanisms resembling desensitization. alpha 2-Adrenoceptor and cholinergic effects may also be attenuated though there is no evidence for altered alpha 1-adrenoceptor sensitivity. The effects of age on sensitivity to benzodiazepines, calcium channel blocking agents, angiotensin converting enzyme inhibitors, anticoagulants and cardiac glycosides are also discussed. There is a major requirement for further work in this field.
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C. G. Swift (1990) conducted a review in Age-related pharmacodynamic changes. Pharmacological agents was evaluated. Age-related changes in homeostatic mechanisms and receptor sensitivity modify drug responses in the elderly, including attenuated beta-adrenoceptor and cholinergic effects.
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