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Related Concept Videos

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...
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

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 Distribution01:00

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 Metabolism01:18

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 Absorption01:22

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 Excretion01:18

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...

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Related Experiment Videos

Pharmacotherapy for hypertension in the elderly.

Vijaya M Musini1, Aaron M Tejani, Ken Bassett

  • 1Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, 2176 Health Science Mall, Vancouver, BC, Canada, V6T 1Z3.

The Cochrane Database of Systematic Reviews
|October 13, 2009
PubMed
Summary

Antihypertensive drug therapy for adults 60 and older with moderate to severe hypertension significantly reduces cardiovascular events and all-cause mortality. However, benefits for all-cause mortality were not observed in individuals over 80 years old.

Related Experiment Videos

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Hypertension prevalence increases with age, particularly after 60.
  • Systolic hypertension is more common and strongly linked to cardiovascular disease in older adults.
  • Evidence on the benefits and harms of treating hypertension in this demographic is crucial.

Purpose of the Study:

  • To evaluate the impact of antihypertensive medications on overall mortality, cardiovascular mortality, and morbidity in individuals aged 60 and above.
  • To assess the rate of treatment withdrawal due to adverse effects in this population.
  • To analyze effects in both mild to moderate systolic or diastolic hypertension.

Main Methods:

  • A comprehensive search of electronic databases (EMBASE, CENTRAL, MEDLINE) and other sources was conducted up to December 2008.
  • Included randomized controlled trials of at least one-year duration comparing antihypertensive drugs with placebo in hypertensive individuals aged 60+.
  • Assessed outcomes included total mortality, cardiovascular morbidity and mortality, and adverse event withdrawals.

Main Results:

  • Fifteen trials involving 24,055 participants demonstrated that treatment reduced total mortality (RR 0.90) and cardiovascular morbidity/mortality (RR 0.72).
  • Benefits were observed in isolated systolic hypertension and in the very elderly (80+) for cardiovascular outcomes, but not total mortality.
  • Withdrawals due to adverse effects increased with treatment (RR 1.71).

Conclusions:

  • Antihypertensive treatment for individuals 60+ with moderate to severe hypertension lowers all-cause mortality and cardiovascular events.
  • The reduction in all-cause mortality was specifically noted in the 60 to 80 age group.
  • Treatment decisions should consider the balance of benefits and risks, especially in the very elderly.