Pharmacological and Pharmacodynamic Implications of Nonsteroidal Anti-Inflammatory Drug Therapy in Elderly Arthritic Patients

There is growing evidence chat elderly patients may be morelikely to develop adverse drug reactions to nonsteroidal anti-inflammatory drug/analgesic therapy. This may be due to the physiological changes which accompanyageing as well as multiple drug therapies commonly used in the elderly. Theelderly may also be more prone to gastrointestinal adverse side effects. There isno satisfactory definition of the elderly. Although age 65 is widely accepted as achronological definition, many elderly persons remain healthy until the age of75, and furthermore, healthy elderly subjects differ little from healthy youngpersons. lt is with the frail elderly, ie, those with multiple diseases and multipledrug therapies, that problems of medication occur. Physiological changes, whichinclude reduced muscle mass, total body water and albumin levels, as well aseffects on renal and hepatic function, affect pharmacokinetic factors, includingabsorption, distribution, biotransformation and renal clearance. Assessment ofthe multiple disease states and resultant organ failure in elderly subjects istherefore necessary