This chapter describes the pharmacological long-term management of serious diseases affecting the older adult: chronic obstructive pulmonary disease, chronic kidney disease, and Parkinson’s disease. The prevalence, role of aging, and modifiable risk factors, pathophysiology, and assessment tools relevant to these diseases are discussed. Advantages and disadvantages of current pharmacotherapy are presented with a focus on the barriers to successful therapy due to comorbidities, polypharmacy, adverse reactions, and age changes in pharmacokinetics/pharmacodynamics.