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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...
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...
Dosage Regimen: Individualization01:24

Dosage Regimen: Individualization

Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
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Dosage Regimens: Partial Pharmacokinetic Parameters

It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
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...

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Increasing polypharmacy - an individual-based study of the Swedish population 2005-2008.

Bo Hovstadius1, Karl Hovstadius, Bengt Astrand

  • 1eHealth Institute, Linnaeus University, Kalmar, Sweden. bo.hovstadius@pwc.se

BMC Clinical Pharmacology
|December 3, 2010
PubMed
Summary

Polypharmacy prevalence increased in Sweden from 2005-2008, with excessive polypharmacy rising 15.7%. This trend affected all ages except young children, with higher increases observed in older adults and men.

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Area of Science:

  • Pharmacology and Public Health
  • Drug utilization studies
  • Epidemiology of medication use

Background:

  • Polypharmacy, defined as the use of multiple drugs, poses significant health risks including adverse drug reactions, interactions, and reduced adherence.
  • Increasing drug use and polypharmacy trends necessitate monitoring for public health policy and clinical practice.
  • Understanding temporal changes in polypharmacy prevalence is crucial for risk management.

Purpose of the Study:

  • To investigate changes in the prevalence of polypharmacy and excessive polypharmacy over a four-year period in the entire Swedish population.
  • To analyze trends in drug dispensing patterns across different age groups and sexes.

Main Methods:

  • Utilized individual-based data on dispensed prescription drugs for the entire Swedish population.
  • Analyzed data from four 3-month periods between 2005 and 2008.
  • Defined polypharmacy as five or more (DP ≥5) and excessive polypharmacy as ten or more (DP ≥10) dispensed drugs per individual within a 3-month period.

Main Results:

  • Polypharmacy (DP≥5) prevalence increased by 8.2% (0.102 to 0.111) and excessive polypharmacy (DP≥10) by 15.7% (0.021 to 0.024) between 2005-2008.
  • Prevalence increased across all age groups except 0-9 years, with the most significant rise in excessive polypharmacy observed in individuals aged 70 and above.
  • The increase in polypharmacy was approximately twice as high for men compared to women, and the mean number of dispensed drugs per person rose by 3.6%.

Conclusions:

  • Polypharmacy and excessive polypharmacy prevalence, along with the average number of dispensed drugs per person, showed a year-on-year increase in Sweden from 2005 to 2008.
  • These findings highlight a growing trend of complex medication use in the Swedish population, particularly among the elderly and males.
  • Continued monitoring and targeted interventions are warranted to mitigate the risks associated with increasing polypharmacy.