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Canadian Journal of Gastroenterology
Volume 4 (1990), Issue 3, Pages 126-130

Pharmacological and Pharmacodynamic Implications of Nonsteroidal Anti-Inflammatory Drug Therapy in Elderly Arthritic Patients

W Watson Buchanan

Rheumatic Disease Unit, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada

Copyright © 1990 Canadian Association of Gastroenterology. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (, which permits reuse, distribution, and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


There is growing evidence chat elderly patients may be more likely to develop adverse drug reactions to nonsteroidal anti-inflammatory drug/analgesic therapy. This may be due to the physiological changes which accompany ageing as well as multiple drug therapies commonly used in the elderly. The elderly may also be more prone to gastrointestinal adverse side effects. There is no satisfactory definition of the elderly. Although age 65 is widely accepted as a chronological definition, many elderly persons remain healthy until the age of 75, and furthermore, healthy elderly subjects differ little from healthy young persons. lt is with the frail elderly, ie, those with multiple diseases and multiple drug therapies, that problems of medication occur. Physiological changes, which include reduced muscle mass, total body water and albumin levels, as well as effects on renal and hepatic function, affect pharmacokinetic factors, including absorption, distribution, biotransformation and renal clearance. Assessment of the multiple disease states and resultant organ failure in elderly subjects is therefore necessary.