Older adults typically have a delayed response to gastric emptying, therefore, this will delay medication absorption. There is also a decreased amount of gastric secretions which will affect mediation absorption (Arcangelo et al., 2017, p. 74).
Older adults naturally have a lower amount of albumin, which is a protein that aids in mediation metabolism. For example, some medications, like propranolol, bind to protein sites. Propranolol is often given for high blood pressure, chest pain, or atrial fibrillation. When the patient takes up less binding sites, the medications takes up more sites and toxicity can occur in the patient. For a patient taking Propranolol, his or her blood pressure may drop more than needed is the dose isn’t adjusted with age (Arcangelo et al., 2017, p. 74).
A drop in lean body mass and an increase in total fat also often occur. This is important to note because some medications are absorbed better by lean body mass and the medication will stay in the elderly patient’s body longer because they don’t have much for lean body mass (Arcangelo et al., 2017, p. 74-75).
The liver metabolizes most of the drugs in the body. In the elderly patients, you see less blood flow and a smaller liver. Again, smaller medication dosages may be needed to prevent hepatic toxicity (Arcangelo et al., 2017, p. 75)
Drug excretion typically happens in the kidneys. Blood flow in the kidneys decreases after the age of 40, so it when giving medications you may have to leave more time between doses to ensure proper clearance (Arcangelo et al., 2017, p. 75).
Drug Therapy
When treating a medical condition like hypertension, the patient will often be prescribed two medications from different classes to fix the problem. This can be beneficial for the patient because less of each medication is being asked to be metabolized through the body. There is a smaller risk the patient will have toxicity of the drug (Huether & McCance, 2017, p. 604).
Furthermore, there are disadvantages for patients taking multiple medications. For example, they are more likely to have a medication reaction. Polypharmacy is a probing problem for older adults, and it cause confusion for these individuals. By keeping there mediations regimen small, compliance is more likely to occur (Agbonjinmi, 2017).
Agbonjinmi, L. A. (2017). Polypharmacy: Inappropriate median use in elderly and its associated
effects. West African Journal Of Nursing, 28(1), 56-65.
Arcangelo, V. P., Peterson, A. M., Wilbur, V. & Reinhold, J. A. (Eds.).
(2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.).
Ambler, PA: Lippincott Williams & Wilkins.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis,
MO: Mosby.
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