Geriatric Pharmacology Research Articles

Digoxin use in the elderly.

The current extensive use of digoxin in elderly patients with left ventricular failure and sinus rhythm may not be clinically justifiable; in a significant proportion of these patients the frequency of digitalis toxicity may outweight the therapeutic benefits of the drug. When digoxin is used in elderly patients, the specific geriatric pharmacology of the drug must be considered. Clinical benefit should be documented before proceeding to long-term maintenance therapy. In selected elderly patients, withdrawal of digoxin with careful follow-up may be a worthwhile procedure. Studies are needed comparing the relative benefits and toxicities of digoxin versus diuretics in the management of heart failure in the elderly.

Book Review: Drugs and the Elderly: Perspective in Geriatric Clinical Pharmacology

Book Review: Drugs and the Elderly: Perspective in Geriatric Clinical Pharmacology

Pharmacokinetic Consequences of Aging

For the purpose of this review we have chosen a rather narrow definition of geriatric pharmacology. We deal with the influence of increasing age on the plasma concen­ tration of a drug and the factors that influence the peak concentration and the rate at which the drug leaves the body. We also discuss what changes in tissue sensitivity occur with age that would affect the overall response to a drug at a given blood level concentration. We do not discuss the extensive literature on the safety and utility of drugs in geriatric patients or the effect of increasing age on the incidence of adverse reactions and altered drug utility. Reviews on these have been published ( 1-5). Not considered as part of this review is one other aspect of geriatric phar­ macology, namely, the effect of drugs on the aging process. Information on this aspect of the subject can be found in other reviews (6,7). We would like to remark on the progress that has been made in our understanding of the effects of age on how a drug is handled by the body and the implications that these changes have on the utility of pharmacological agents in the treatment of diseases of old age. Until recently, most of the work has concerned the use of drugs in the elderly patient to determine their safety and their efficacy. There have been few comparisons with the response in younger populations. Even when such com­ parisons have been made, however, there have been few attempts to explain the reason for these differences and the basic biological rationale for them. In the last several years, however, greater attention has been focused on the effect of age on mechanisms responsible for drug disposition, and we are gradually laying the foun­ dation for understanding how drugs may be more effectively used in the treatment of diseases of the elderly patient (813). It is our hope that the review of this biological rationale, and more specifically the pharmacokinetic aspects of increasing age, will contribute to this understanding.

Perspectives for psychopharmacologic research in gerontology.

A contribution to gerontologic research is offered by the study of aging as a series of alterations in the efficiency of body processes in response to the administration of drugs. Geriatric pharmacology involves the use of drugs for: 1) preventive therapy and rejuvenation, 2) the treatment of disease, and 3) ascertaining the pathologic and physiologic status of the patient. Only rarely do gerontologic studies entail the manipulation of particular factors in order to reveal their effects in altering the aging process (which should be the dependent variable). Aging offers a fascinating panorama of phenomena for research. Scientists from other fields could well be persuaded put their knowledge and skills to work in this field.

Sensitivity of central nervous structures to humoral factors in aging

Experiments on adult and old animals (white rats and rabbits) have shown that the sensitivity of the central nervous structures to the action of catechol-amines, acetylcholine, insulin and to various central stimulators (camphor, cordiamin, corazol, amidopyrine) increases with senescence. The results obtained are important for the understanding of the pecularities of the central regulatory processes depending upon ageing, and may be of value in geriatric pharmacology.

Geriatric pharmacology--a descriptive definition.

Journal of the American Geriatrics SocietyVolume 14, Issue 10 p. 1013-1015 Article GERIATRIC PHARMACOLOGY—A DESCRIPTIVE DEFINITION A. Douglas Bender Ph.D., Corresponding Author A. Douglas Bender Ph.D. Philadelphia, PennsylvaniaAddress: Research and Development Division, Smith Kline and French Laboratories, 1500 Spring Garden Street, Philadelphia, Pennsylvania 19101.Search for more papers by this author A. Douglas Bender Ph.D., Corresponding Author A. Douglas Bender Ph.D. Philadelphia, PennsylvaniaAddress: Research and Development Division, Smith Kline and French Laboratories, 1500 Spring Garden Street, Philadelphia, Pennsylvania 19101.Search for more papers by this author First published: October 1966 https://doi.org/10.1111/j.1532-5415.1966.tb02882.xCitations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume14, Issue10October 1966Pages 1013-1015 RelatedInformation

Clinical Principles and Drugs in the Aging

If this book stayed strictly with its subject, it would be no more than half its present size. Most of its chapters do not explore the specific problems of geriatric pharmacology and therapeutics, but merely pay it lip service by providing a general resume and citing a few exceptions or indicating that it differs little in the aged from that in others. Much that is said seems to be based on reasonableness rather than on proved differences.