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Aging and Drug Therapy by I. H. Stevenson (auth.), G. Barbagallo-Sangiorgi, A. N.

By I. H. Stevenson (auth.), G. Barbagallo-Sangiorgi, A. N. Exton-Smith (eds.)

One of the best advances in Geriatric medication over the last region of a century has been the elevated awareness of the chances of therapy for aged sufferers. forget has been changed by way of a extra positive healing endeavour and numerous outdated humans have benefitted from this strategy. yet there's additionally an obstacle, and this is often the danger of unsafe uncomfortable side effects of drugs that are frequently without delay proportional to the organic efficiency of the drug and will be unpredictably elevated as a result of adjustments within the senile organism. actually the anatomical and organic alterations in previous age modify either the kinetics of so much medicinal drugs and the receptor reaction. because of those adjustments the person tolerance of elderly sufferers to drug remedy could be fairly assorted from that of more youthful topics. hence for quite a few purposes aged sufferers obtain extra medications, yet they're at a better chance of encountering hostile reactions, which regularly convey strange scientific gains. we will as a result communicate of "geriatric iatrogenic issues" and indicate that a few of these negative effects are made up our minds by means of a fancy pathogenesis a result of specific pathophysiological within the aged. it is very important inspire the behavior of individ­ ually comparing strength probability as opposed to anticipated merits of gear in line with an identical rules followed within the review of cost/benefit ratio.

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Severson, and C. E. Finch, Aging and the regulation of striatal dopaminergic mechanisms in mice, J. 2l9:695 (1981). M. Roffman, F. Cordasco, and A. Psychopharmacol. 4:283 (1980). S. Algeri, G. Calderini, G. Lomuscio, G. Toffano, and F. Ponzio, Catecholamines and adaptive mechanisms in senescent rats, in: "Apomorphine and other Dopaminomimetics, Vol. 2 Clinical Pharmacology," G. U. Corsini and G. L. , Raven Press, New York (1981). V. Jonec, and C. F.. Finch, Ageing and dopamine uptake by subcellular fractions of the C57BL/6J male mouse brain, Brain Res.

J. Caranasos, R. B. Stewart, L. E. Ass. 228:713 (1974). C. M. Castleden, C. F. Pharmacol. 7:49 (1979). K. A. Conrad, R. ,"Drug Therapy for the Edlerly," C. V. , St. Louis (1982). J. Crooks, 1. H. , "Drugs and the Elderly," MacMillan Press Ltd. London (1979). W. Davison, Iatrogenic brain failure, in: "The Aging Brain: Neurological and Mental DisturbanceS," G. Barbagallo Sangiorgi and A. N. , Plenum Press, New York and London (1980). S. Soc. , Parma 7-9 Ottobre, Suppl. 48:8 (1972). S. Garattini, P.

Love, P. R. Soc. 30:329 (1982) GENERAL SYMPTOMATOLOGY OF PATHOGENIC DRUG USAGE IN OLD PATIENTS G. Barbagallo Sangiorgi Department of Medical Pathology University of Palermo, Italy PRELIMINARY CONSIDERATIONS Drug administration involves the risk of unwanted side effects in patients of any age. This risk is considerably higher in older patients,S as is sho~m by several statistics on this subject. 8 , 16, . e. a) aged patients often suffer from more than one ailment at a time and are therefore treated with various drugs characterized by different mechanisms of action; b) reduced patient's compliance with the physician's prescriptions involving mistakes both by defect and by excess;11 c) self-prescription, particularly of laxatives, analgesics and often also of diuretics; d) senile alteration in pharmacokinetics 1,11,13,19 concerning both liver metabolism (due to alterations of microsome enzyme activity) ana plasma transport (due to decreased serum albumin concentration) and excretion function (due to decreased renal clearance); the influence exerted by environmental factors (by smoking, that favours senile alterations in pharmacokinetics) and by coexisting pathologic conditions has been demonstrated for some drugs such as antipyrin and propranolol; e) senile alterations of receptor response to drugs determine a different sensitivity of several target organs to drug action.

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