The Impact of Ageing on Pharmacokinetics

Abstract

The process of human ageing is associated with significant changes affecting cellular homoeostasis and the structure and function of organs and systems. Some of these changes may influence the pharmacokinetics of medications, with consequent drug accumulation, increased risk of drug–drug and drug–disease interactions and overt toxicity in the older population, the largest medication consumer group. This chapter describes the current knowledge on the effects of advancing age on the structure and function of critical organs and systems and the four pillars of pharmacokinetics, absorption, distribution, metabolism and elimination. It also discusses areas of uncertainty and opportunities for practical applications, particularly with the use of pharmacokinetic data to develop and implement personalised prescribing tools to assist clinical decisions. A better understanding of the main pharmacokinetic changes associated with ageing, and the implementation of robust strategies to ensure the quality use of medicines by healthcare professionals, is likely to augment therapeutic efficacy and minimise toxicity in the older patient population.