Geriatric Pharmacology Overview

This age of pharmacology and geriatric psychiatry requires an appreciation for the pharmacology of aging. Suboptimal prescribing, which affects 25% of those aged 65–69 years and 45% of those aged 70–79 (Charlesworth et al., J Gerontol A Biol Sci Med Sci 70:989–995, 2015), can result in increased risk of adverse effects. This chapter reviews common medication adverse effects and risks as well as approaches which can minimize their frequency and severity. The effectiveness of pharmacological treatments for specific conditions is covered in the other chapters. We review factors such as inappropriate polypharmacy, as well as unnecessary, ineffective, or harmful medications and their potential for harm. Risks are significant especially for geriatric patients, for whom the physiological changes of aging, in combination with the high prevalence of chronic medical conditions, alter (1) the ways that medications are processed by the body (pharmacokinetics) and (2) the effects of medications on the body (pharmacodynamics).