Geriatric Anesthesia: A Practical Guide

Pharmacology in Geriatric Anesthesia

Author(s): Reuben D’Souza and George Hsu *

Pp: 23-40 (18)

DOI: 10.2174/9789815238877124010005

* (Excluding Mailing and Handling)


In terms of different pharmacokinetic and pharmacodynamic interactions, geriatric patients exhibit greater sensitivity to anesthetics. Therefore, understanding the differences in body composition, hepatic and renal function, changes in protein binding, and minimal alveolar concentration are the key to titration of anesthetics in geriatric patients. In addition, polypharmacy, use of non-prescription medications and adverse medications related events warrant special considerations for the geriatric population, more so than in their younger counterparts. Lastly, careful titration of anesthetics may minimize the development of postoperative delirium and postoperative cognitive dysfunction, which are associated with higher morbidity, mortality, length of hospitalization, and overall cost.

Keywords: Geriatric anesthesia, Geriatric pharmacology, Geriatric pharmacokinetics, Geriatric pharmacodynamics, Geriatric body composition, Geriatric hepatic function, Geriatric renal function, Protein binding, Minimum alveolar concentration, Geriatric anesthetic dosing, Geriatric polypharmacy, Beers criteria.

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