Prescribing in older people

Abstract

Background: Prescribing medications to older people is difficult due to comorbidity, limited evidence for efficacy, increased risk of adverse drug reactions, polypharmacy, and altered pharmacokinetics.

Objective: This article describes the principles underlying clinical geriatric pharmacology including approaches to evaluating the evidence for risk and benefit, and adjusting dose for age related pharmacokinetic changes.

Discussion: The challenge for the general practitioner is to balance an incomplete evidence base for efficacy in frail, older people against the problems related to adverse drug reactions without denying older people potentially valuable pharmacotherapeutic interventions.