Oral anticoagulants - Pharmacologic issues for use in the elderly

Clinical indications for oral anticoagulant therapy have greatly expanded, particularly among the elderly. Optimal use of oral anticoagulants in the geriatric population requires an understanding of the mechanism of action of warfarin and the pharmacokinetic and pharmacodynamic differences in this age group. Many factors affect the dose response of warfarin and the stability of anticoagulation control, including age, medications, diet, and comorbid illness. Important considerations in the initiation of warfarin dosing and the long-term management of anticoagulation in the elderly are discussed.