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Certain drugs are excreted via expiration; the rate of excretion depends on plasma concentration, alveolar air concentration and blood-gas partition. Anaesthetic gases are the only group of drugs that are significantly excreted in expired air. A small amount of alcohol is excreted in this way but this accounts for only a small proportion of the overall elimination. Loss of drugs in sweat and breast milk occurs, but is of minor importance although the appearance of drugs in breast milk can have serious consequences for the nursing baby. Drugs can be administered to patients by a variety of routes and can be intended to have a local or systemic effect.

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Factors affecting compliance in older people are many and include the complexity of multiple therapy, possible difficulty in understanding instructions, ambiguous or unclear patient information or labelling, preconceived ideas about medicines and their benefits, previous bad experience, difficult dosing regimes, unpalatable formulations and real or imagined side effects. As we get older, there are physiological changes that can alter the effect a drug has on the body.

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