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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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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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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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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...
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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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Updated: Jun 10, 2026

In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears
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Published on: February 21, 2018

Meniere's disease in the elderly.

Dominique Vibert1, Marco Caversaccio, Rudolf Häusler

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University of Berne, 3010 Berne, Switzerland. dominique.vibert@insel.ch

Otolaryngologic Clinics of North America
|August 18, 2010
PubMed
Summary

Menière disease treatment in the elderly is challenging due to multiple medications. Safe options include betahistine and cinnarizine, while thiethylperazine should be avoided. Surgical options exist for severe cases.

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In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears
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Published on: February 21, 2018

Endolymphatic Duct Blockage as a Surgical Treatment Option for Ménière's Disease
04:11

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Published on: April 28, 2023

Area of Science:

  • Neurology
  • Otolaryngology

Background:

  • Menière disease commonly affects adults aged 20-60.
  • Over 10% of patients over 65 experience Menière disease.
  • Treating elderly patients with Menière disease is complicated by polymedication.

Purpose of the Study:

  • To review Menière disease treatment strategies in the elderly.
  • To highlight challenges and safe therapeutic options for older adults.

Main Methods:

  • Review of current literature on Menière disease management in the elderly.
  • Analysis of drug efficacy and side effect profiles.
  • Evaluation of surgical interventions for refractory symptoms.

Main Results:

  • Antivertiginous drugs like betahistine and cinnarizine show good efficacy with minimal side effects.
  • Major vestibular suppressants, such as thiethylperazine, should be avoided for long-term use due to adverse effects.
  • Surgical deafferentation (labyrinthectomy, vestibular neurectomy) are options requiring case-by-case evaluation.
  • Ablative procedures are effective for managing potentially injurious drop attacks.

Conclusions:

  • Pharmacological management of Menière disease in the elderly requires careful consideration of drug interactions and side effects.
  • Betahistine and cinnarizine are recommended first-line treatments.
  • Surgical interventions should be reserved for carefully selected cases, particularly for managing severe drop attacks.