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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...

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...

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...

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...

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Updated: Jun 23, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Do geriatric outpatients adhere to medication changes advised after assessment? An exploratory pilot study.

Linda R Tulner¹, Suzanne V Frankfort, Floor Wesselius

¹Department of Geriatric Medicine, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The Netherlands. geltu@slz.nl

Current Clinical Pharmacology

|May 16, 2009

Summary

Most older adults adhere to medication changes after a Comprehensive Geriatric Assessment (CGA). Caregiver involvement significantly improves adherence, highlighting the need for support when caregivers are absent.

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Last Updated: Jun 23, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Area of Science:

Geriatric Medicine
Pharmacology
Patient Adherence Research

Background:

Medication adjustment is a common outcome of Comprehensive Geriatric Assessment (CGA).
Patient adherence to medication changes post-CGA is often suboptimal.
Identifying patients at high risk for non-adherence is crucial.

Purpose of the Study:

To evaluate the extent to which patients implement medication changes recommended after CGA.
To identify factors associated with medication non-adherence in the geriatric population.

Main Methods:

Assessed co-morbidity and medication use in geriatric patients.
Interviewed patients (and caregivers if applicable) regarding medication changes.
Utilized univariate logistic regression to analyze factors influencing non-adherence.

Main Results:

90% of advised medication changes were reportedly implemented.
65% of patients demonstrated overall compliance with medication regimens.
Caregiver presence was linked to higher reported adherence.
Many patients lacked clarity on the prescribed duration of their medications.

Conclusions:

The majority of geriatric patients adhere to medication adjustments post-CGA.
Caregiver supervision appears to facilitate adherence, even with polypharmacy and cognitive impairment.
Enhanced patient education on drug therapy duration and increased attention to adherence in the absence of caregivers are recommended.