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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 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...
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 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...
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.

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Preoperative geriatric assessment: comprehensive, multidisciplinary and proactive.

Sheilesh Kumar Dewan1, Song Bai Zheng, Shi Jin Xia

  • 1Department of Geriatric Medicine, Huadong Hospital affiliated to Fudan University, 221 West Yan'An Road, Shanghai 200040, China. sheilesh_d1@hotmail.com

European Journal of Internal Medicine
|August 7, 2012
PubMed
Summary

Comprehensive preoperative assessment is crucial for elderly surgical patients. A multidisciplinary approach helps identify risks and optimize care, improving surgical outcomes for older adults.

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Area of Science:

  • Geriatric Medicine
  • Surgical Services
  • Perioperative Care

Background:

  • Global demographics show an increasing elderly population, straining surgical services.
  • Elderly patients have unique physiological, psychological, functional, and social needs requiring tailored preoperative attention.
  • Advances in surgery and anesthesia reduce reluctance to operate on older adults.

Purpose of the Study:

  • To review current geriatric risk assessment tools for surgery.
  • To advocate for a comprehensive, multidisciplinary, and proactive preoperative approach for elderly patients.
  • To demonstrate how this approach can enhance perioperative outcomes.

Main Methods:

  • Review of existing literature on geriatric preoperative assessment tools.
  • Analysis of the benefits of a multidisciplinary and proactive preoperative strategy.
  • Discussion of risk factor detection and early intervention planning.

Main Results:

  • Chronological age is no longer an absolute exclusion criterion for surgery.
  • Comprehensive assessment identifies multiple risk factors and comorbidities in older patients.
  • Proactive interventions and planning improve the perioperative period.

Conclusions:

  • A multidisciplinary, proactive preoperative assessment is vital for safe and effective surgical care in the elderly.
  • Individualized attention to the specific needs of older patients is paramount.
  • This approach can significantly improve perioperative outcomes for geriatric surgical patients.