Aging effects on drug disposition and effect

Drug therapy in older individuals has generally been summarized in the phrase 'start low and go slow'. As better understanding of the effects and disposition of drugs in the aged has evolved, the concept of 'therapeutic burden' which encompasses the number of concurrent medications as well as the dose of medications administered has assumed considerable importance. Epidemiologic and surveillance data demonstrate that drug therapy, in addition to offering improvement in quality and quantity of life, is also a major source of morbidity for the aged patient. These data and advances in understanding the pathophysiology of aging for individual patients which contribute to understanding of age related changes in drug response are discussed.