Drug metabolism in the elderly: A multifactorial problem?

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Drug metabolism in the elderly: A multifactorial problem? / Waring, Rosemary; Mitchell, S. C.

In: Maturitas, Vol. 100, 01.06.2017, p. 27-32.

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Waring, Rosemary ; Mitchell, S. C. / Drug metabolism in the elderly: A multifactorial problem?. In: Maturitas. 2017 ; Vol. 100. pp. 27-32.

Bibtex

@article{eab2873bf2b048268314533edcb2f9a7,
title = "Drug metabolism in the elderly:: A multifactorial problem?",
abstract = "Whether or not an individual{\textquoteright}s drug metabolising capacity declines with advancing age is a vexing question. There is no clear evidence that drug metabolism itself ({\textquoteleft}the biologically-assisted chemical alteration of the administered parent molecule{\textquoteright}) is less efficient in healthy old age than at younger ages, whereas a decreased capacity may be associated with ill-health and frailty. However, elderly individuals do show a reduced enzyme induction capability and are less able to tolerate overdoses. It appears that the majority of deleterious clinical outcomes related to drug therapy in an elderly (usually ill or frail) population may be ascribed to various anatomical and physiological age-related changes. These may affect both pharmacodynamics and pharmacokinetics, but not necessarily drug metabolism. Information gleaned from animal studies undertaken mainly in rodents does not seem to be of relevance to humans and studies in healthy aged human populations may not highlight possible problems. However, certain circumstances may influence metabolic competence, and phenotyping rather than genotyping is of more value in identifying those susceptible to adverse drug reactions. This short review discusses the potential contributions of four factors (inflammation, circadian rhythm, gut microbes, epigenetic aspects) which may lead to alterations in drug metabolism with increasing age.",
keywords = "Age effect , Xenobiosis , Inflammation , Circadian rhythm , Gut microbiota , Epigenetic factors",
author = "Rosemary Waring and Mitchell, {S. C.}",
year = "2017",
month = jun,
day = "1",
doi = "10.1016/j.maturitas.2017.03.004",
language = "English",
volume = "100",
pages = "27--32",
journal = "Maturitas",
issn = "0378-5122",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Drug metabolism in the elderly:

T2 - A multifactorial problem?

AU - Waring, Rosemary

AU - Mitchell, S. C.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Whether or not an individual’s drug metabolising capacity declines with advancing age is a vexing question. There is no clear evidence that drug metabolism itself (‘the biologically-assisted chemical alteration of the administered parent molecule’) is less efficient in healthy old age than at younger ages, whereas a decreased capacity may be associated with ill-health and frailty. However, elderly individuals do show a reduced enzyme induction capability and are less able to tolerate overdoses. It appears that the majority of deleterious clinical outcomes related to drug therapy in an elderly (usually ill or frail) population may be ascribed to various anatomical and physiological age-related changes. These may affect both pharmacodynamics and pharmacokinetics, but not necessarily drug metabolism. Information gleaned from animal studies undertaken mainly in rodents does not seem to be of relevance to humans and studies in healthy aged human populations may not highlight possible problems. However, certain circumstances may influence metabolic competence, and phenotyping rather than genotyping is of more value in identifying those susceptible to adverse drug reactions. This short review discusses the potential contributions of four factors (inflammation, circadian rhythm, gut microbes, epigenetic aspects) which may lead to alterations in drug metabolism with increasing age.

AB - Whether or not an individual’s drug metabolising capacity declines with advancing age is a vexing question. There is no clear evidence that drug metabolism itself (‘the biologically-assisted chemical alteration of the administered parent molecule’) is less efficient in healthy old age than at younger ages, whereas a decreased capacity may be associated with ill-health and frailty. However, elderly individuals do show a reduced enzyme induction capability and are less able to tolerate overdoses. It appears that the majority of deleterious clinical outcomes related to drug therapy in an elderly (usually ill or frail) population may be ascribed to various anatomical and physiological age-related changes. These may affect both pharmacodynamics and pharmacokinetics, but not necessarily drug metabolism. Information gleaned from animal studies undertaken mainly in rodents does not seem to be of relevance to humans and studies in healthy aged human populations may not highlight possible problems. However, certain circumstances may influence metabolic competence, and phenotyping rather than genotyping is of more value in identifying those susceptible to adverse drug reactions. This short review discusses the potential contributions of four factors (inflammation, circadian rhythm, gut microbes, epigenetic aspects) which may lead to alterations in drug metabolism with increasing age.

KW - Age effect

KW - Xenobiosis

KW - Inflammation

KW - Circadian rhythm

KW - Gut microbiota

KW - Epigenetic factors

U2 - 10.1016/j.maturitas.2017.03.004

DO - 10.1016/j.maturitas.2017.03.004

M3 - Article

VL - 100

SP - 27

EP - 32

JO - Maturitas

JF - Maturitas

SN - 0378-5122

ER -