PHARMACOLOGICAL CHARACHTERISTICS IN THE ELDERLY POPULATION.

The elderly are the fastest increasing population with multiple comorbidities and polypharmacy. They are especially prone to pain, both chronic and neuropathic, and treatement in the geriatric context should be based on balancing between benefits and risks. The process of aging includes multiple changines in the structure, neurochemistry and function of the nociceptive pathways, and also a significant reduction in the functioning of the endogenous inhibitory analgesic pathway. Because of the comorbidities, the elderly often use multiple drugs and in the context of changed physiology, especially pharmacokinetics, there is a big risk factor for side effects. Holistic geriatric assessment is a useful tool in the prevention of circulus vitiousus in the farmacotherapy of pain. Generally the conclusion is that analgetics which are used in the younger adult population are useful in the elderly as well, but the ratio between risks and benefit should be carefully evaluated. Recommendations for pharmacological treatement of pain in this vulnerable population are based on safety rather than efficacy. [ABSTRACT FROM AUTHOR]