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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...

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Experimental Approach to Examine Leptin Signaling in the Carotid Bodies and its Effects on Control of Breathing
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Published on: October 25, 2019

Twenty-four-hour variation in serum leptin in the elderly.

R Franceschini1, G Corsini, A Cataldi

  • 1Department of Internal Medicine, University of Genoa, Italy.

Metabolism: Clinical and Experimental
|August 25, 1999
PubMed
Summary
This summary is machine-generated.

Aging preserves the diurnal rhythm of serum leptin (a hormone regulating appetite). However, elderly individuals show a reduced amplitude in this daily variation, potentially impacting appetite regulation.

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Area of Science:

  • Endocrinology
  • Chronobiology
  • Gerontology

Background:

  • Serum leptin levels exhibit diurnal variation, influenced by factors like age.
  • Understanding age-related changes in leptin rhythm is crucial for metabolic health insights.

Purpose of the Study:

  • To investigate how the aging process affects the diurnal variation of serum leptin in humans.
  • To compare leptin rhythmicity between elderly and middle-aged lean men.

Main Methods:

  • Serum leptin was measured using radioimmunoassay in 12 elderly (72-87 years) and 10 middle-aged (35-50 years) lean males.
  • Blood samples were collected every 2-4 hours over a 24-hour period.
  • Circadian rhythmicity was analyzed using the cosinor method.

Main Results:

  • Elderly subjects exhibited a preserved diurnal rhythm of serum leptin, similar to controls.
  • While mesor (mean value) was similar, elderly individuals showed a decreased amplitude and an earlier acrophase (peak time) compared to middle-aged subjects.
  • A significant rhythm was detected in 8/12 elderly and 9/10 middle-aged subjects.

Conclusions:

  • The diurnal variation of serum leptin is generally maintained in the elderly.
  • Advancing age leads to a reduction in the amplitude of leptin's diurnal excursion.
  • Blunted diurnal variation in elderly individuals may alter adipose tissue-central nervous system signaling.