The fibrosis-plasticity axis (FPA) and ionic resilience: a systems framework for understanding adverse drug reactions in ageing populations
Alejandro Carballo
BackgroundOlder adults frequently develop disabling adverse drug reactions (ADRs) from standard-dose medications despite lacking clear organ pathology and presenting with normal serum electrolyte values. Traditional explanations focusing on altered pharmacokinetics or pharmacodynamics inadequately explain why adverse effects often span multiple organ systems and resist prediction by standard clinical parameters.ObjectiveTo develop a unified theoretical framework—the Fibrosis-Plasticity Axis (FPA