Editing Pharmacology (section)

== Special Populations ==

'''Older adults.''' Reduced renal clearance, reduced hepatic metabolism, lower lean body mass, and lower albumin all increase drug effect. Polypharmacy compounds risk. Beers Criteria drugs to use with caution include benzodiazepines, first-generation antihistamines such as diphenhydramine, strong anticholinergics, and certain sedative hypnotics because of falls, delirium, and urinary retention. Start low and go slow.

'''Pediatrics.''' Dosing is weight based or body-surface-area based. Always verify the safe dose range. Avoid aspirin in children and adolescents with viral illness because of Reye syndrome.

'''Pregnancy and lactation.''' The former lettered categories were replaced by the Pregnancy and Lactation Labeling Rule, which uses narrative risk summaries. Known teratogens or drugs contraindicated in pregnancy include warfarin, ACE inhibitors and ARBs, isotretinoin, methotrexate, statins, tetracyclines, and valproate.

'''Renal and hepatic impairment.''' Adjust or avoid renally cleared and hepatically metabolized drugs, and monitor levels when available.