Table 1.

Pharmacokinetic and pharmacodynamic properties of drugs in geriatric patients

Drug	Pharmacokinetic	Pharmacodynamic
Thiopentone (85%reduction), Etomidate	Decreased initial volume of distribution (Vd). decreased clearance (half-life 13-25 h versus 6-12 h in young)
Propofol, midazolam	Decreased clearance	Increased brain sensitivity
Morphine (morphine-6 glucuronide)	Decreased clearance	Reduced renal clearance Increased brain sensitivity
Fentanyl, sufentanil, alfentanil		Increased brain sensitivity
Remifentanil	Reduced central compartment volume	Increased brain sensitivity
Neuromuscular blockers	Prolonged action of drug undergoing hepatic metabolism Dose unchanged
Neostigmine	Dose unchanged	More cardiac adverse effects