You should consider the following points

1. Perform an extensive review of the cardiopulmonary status of geriatric patients; abscence of complaints may be caused by a sedentary life style

2. Review the medical management of systemic disease (polypharmacy); carefull blood pressure monitoring especially when taking antihypertensive, diuretic, antidepressant, anti-Parkinsonian, and erectile dysfunction agent

3. There are significant changes in the pharmacokinetic and pharmacodynamic behavior of opioids, propofol, thiopental, midazolam, and etomidate in the geriatric patient; smaller doses, slow and carefull titration to avoid overdosing, hypotension and delayed awakening in the older patient.

Geriatric pharmacology

• Opioids
• Hypnotic Anesthetics
• Inhalational Anesthetics
• Relaxants
• Local Anesthetics

Links

1. Ginsberg G, Hattis D, Russ A, Sonawane B. Pharmacokinetic and Pharmacodynamic Factors That Can Affect Sensitivity to Neurotoxic Sequelae in Elderly Individuals. Environ Health Perspect. 2005 Sep;113(9):1243-9.
2. McLean AJ, Le Couteur DG.Aging biology and geriatric clinical pharmacology. Pharmacol Rev. 2004 Jun;56(2):163-84.