In a person older than 65, any adjustment in the strength and/or the frequency of drug administration designed to minimize the risk of adverse drug reactions. Older patients should typically begin a new drug regimen by taking a smaller dose of a pharmaceutical agent than younger individuals.
CAUTION!In general, older people metabolize drugs more slowly than younger ones. Slower metabolism may produce higher drug concentrations or longer half-lives. In addition older people often excrete drugs more slowly than the young. Subtle impairments in kidney or liver function that occur with aging often combine to increase the risk of drug toxicity. Drugs that frequently impair thinking in the elderly include sedatives, hypnotics, analgesics, anticholinergics, and psychotropic medications. NSAIDs and anticoagulants are more likely to cause bleeding in older people than younger ones; NSAIDs also pose an increased risk of kidney failure in the elderly. This brief list of potential pharmaceutical problems in the elderly is not meant to be comprehensive. Before administering any drug to an older patient, it is prudent to assess the proposed benefits of the treatment relative to known risks.