Drug use in elderly & integrative medicine

Patients ?65 years old are 9-12% of the population and consume more drugs than younger population. Functional capacity of the major organ systems declines as age increases, resulting in altered pharmacokinetics of some drugs. Diminished/blunted homeostatic responses and altered drug-receptor interactions result in pharmacodynamic changes, which makes the elderly more sensitive to drug action. Geriatric patients use approximately 3-5 drugs daily; addition of non-prescribed, herbal medications (ginseng, gingko biloba, glucosamine etc.) under the scope of integrative medicine inevitably increases this number. Use of more than five drugs concurrently increases the incidence of adverse drug reactions and/or drug-drug interactions up to 100%. While prescribing in elderly, careful drug history including the use of vitamins and herbal medications should be taken to prevent any potential drug interactions. This article is focused on the alterations in drug pharmacokinetics and pharmacodynamics in elderly, basic principles of prescribing and integrative medical approaches in advanced age. Copyright © 2009 by Türkiye Klinikleri