Clinical Pharmacology of Hepatoprotective Agents in Older Adults

Abstract

This article examines the clinical pharmacological characteristics of hepatoprotective agents in older adults, with particular attention to their pharmacodynamic and pharmacokinetic properties, therapeutic use, and medication safety. Age-related physiological changes, including alterations in hepatic blood flow and metabolic capacity, together with the high prevalence of polypharmacy among older patients, require an individualized approach to pharmacotherapy. In this population, changes in hepatic drug metabolism and the simultaneous use of multiple medications may increase the risk of adverse drug reactions and clinically relevant drug-drug interactions. The article discusses the principal pharmacological mechanisms attributed to agents with hepatoprotective properties, including their potential effects on hepatocellular membranes, oxidative stress, inflammatory processes, and bile metabolism. Particular attention is given to the selection of pharmacotherapy according to the etiology of liver disease, the patient's age, comorbid conditions, hepatic functional status, concomitant medications, and the potential risk of adverse reactions. From a modern clinical perspective, identification and management of the underlying cause of liver injury remain fundamental principles of treatment. In cases of suspected drug- or supplement-induced liver injury, identification and, when clinically appropriate, withdrawal of the causative agent are central components of management.