ABSTRACT
This chapter explores how the process of ageing affects the body and considers how the effects of ageing influence how medicines work. It also considers the concepts of polypharmacy, self-administration of medicines, self-medication and concordance/adherence. The ageing issues are clearly recognised by National Service Framework for Older People. The size of the liver decreases with age, although the rate at which this happens varies both within the same individual and between individuals. From the medicines management perspective, the results of this are two-fold. Not only will the liver have less blood circulating through it but it will also have fewer cells to produce the enzymes needed for metabolism and excretion. A number of drug groups show a markedly increased effect on the brain when given to older people. This effect is seen most commonly with opioid analgesics, benzodiazepines, antipsychotics and antiparkinsonian drugs. Age-related changes in the body's physiology affect pharmacokinetic process and consequently lead to altered pharmacodynamics in older person.
