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Drug Dosing: Geriatric Patients

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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...

Pharmacodynamics in Geriatric Patients: Effects of Age

Pharmacodynamics in Geriatric Patients: Effects of Age

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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Generation of Recombinant Human IgG Monoclonal Antibodies from Immortalized Sorted B Cells

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Anti-aging medicine. What makes it different from geriatrics?

R N Butler¹, M Fossel, C X Pan

¹Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, USA.

|June 29, 2000

Summary

Anti-aging medicine prompts physicians to reconsider aging. While diet and exercise are beneficial, unproven hormone and mega-vitamin therapies remain controversial, influencing treatment decisions.

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Area of Science:

Gerontology and Internal Medicine
Preventive Medicine

Background:

The rise of "anti-aging" medicine necessitates a critical examination of physicians' perspectives on aging.
Key questions involve defining aging as pathology versus a natural life cycle stage and the feasibility of disease-free longevity.

Purpose of the Study:

To explore the evolving landscape of anti-aging medicine and its implications for clinical practice.
To analyze the various modalities employed in anti-aging interventions and their scientific validity.

Main Methods:

Review of current practices and literature concerning anti-aging therapies.
Analysis of the roles of hormone replacement, supplements, diet, and exercise in longevity.
Examination of the controversial aspects of unproven therapies.

Main Results:

Diet, exercise, and certain supplements are recognized preventive health measures.
Hormone therapies, mega-vitamin regimens, and herbal treatments are often controversial and lack robust evidence.
Patient and physician values significantly impact treatment choices in anti-aging medicine.

Conclusions:

Physicians must critically evaluate the scientific basis of anti-aging claims.
A balanced approach is needed, distinguishing evidence-based preventive strategies from unproven interventions.
Shared decision-making, informed by both scientific evidence and personal values, is crucial.