Cardiac drugs: Adjusting their use in aging patients

Reduced drug metabolism, both renal and hepatic, occurs with aging. Algorithms for dose adjustments of renally excreted drugs are available, but dose adjustments must be empiric for drugs which undergo hepatic metabolism. Decreased drug clearance in combination with potentially increased sensitivity to durgs in the elderly means that, as a general rule, drug dosages should be reduced as the age of the patient increases. The frequent need for multi-drug therapy may also lead to adverse effectts in the elderly compared with younger cardiac patients. Managing the geriatric patient requires careful drug monitoring and a heightened awareness of the potential for adverse drug effects.