creatinine clearance and glomerular filtration rate, requiring considerations for drugs eliminated through the renal system. In terms of pharmacodynamics, receptors or receptor sites vary with age, affecting drug action in different ages. Age also determines post-receptor events and adaptive homeostatic responses to the drug. For example, aging increases the effect of warfarin on the body.

In lieu of the above phamacotherapeutic changes with age, the gliclazide. Regarding warfarin, I would strongly assess the risk for falls and bleeding to determine the need to replace it with a low-dose heparin. For an older patient, I would reduce warfarin doses, and replace it with heparin if the risk for falling and bleeding increases. For aspirin, I would not change it; unless if the risk of bleeding occurs. Also, the dosage will vary with age. As regards metformin, there are no contradictions with its use in relation to age. If patient HM is over 60 years, one may want to change Atenolol, but the patient also has ischemic heart disease (Schumann &Hickner, 2008). Additionally, I would like to review the use of motrin if the age is advanced, or because of the possible adverse effects due to interactions with aspirin.

References

O’Mahoney, D., & O’Connor, N.M. (2011).Pharmacotherapy at the end of life.Age and Ageing, 40(4), 419-422.

Schumann, S.,&Hickner, J. (2008).When not to use beta-blockers in seniors with hypertension.The Journal of Family Practice, 57(1), 18-21.