Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

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 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 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 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...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study.

Sao Paulo medical journal = Revista paulista de medicina·2022

Same author

Potentially inappropriate medication use in hospitalized elderly patients.

Revista da Associacao Medica Brasileira (1992)·2022

Same author

Beers AGS 2019 criteria in very old hospitalized patients.

Revista da Associacao Medica Brasileira (1992)·2020

Same author

Over-the-counter medications potentially inappropriate for the elderly.

Revista da Associacao Medica Brasileira (1992)·2018

Same author

Anemia in elderly residents of a long-term care institution.

Hematology, transfusion and cell therapy·2018

Same author

Neuropsychiatric symptoms and severity of dementia.

Dementia & neuropsychologia·2017

Search research articles

Related Experiment Videos

Potentially inappropriate medications in elderly.

Milton Luiz Gorzoni¹, Renato Moraes Alves Fabbri, Sueli Luciano Pires

¹Departamento de Clínica Médica, Faculdade de Ciências Médicas, Santa Casa de São Paulo, Brasil. 　gorzoni@uol.com.br

Revista Da Associacao Medica Brasileira (1992)

|August 30, 2012

Summary

The PRISCUS and Beers-Fick criteria both help identify potentially inappropriate medications (PIMs) in older adults. However, neither criterion fully captures the medication realities in Brazilian outpatient settings.

Related Experiment Videos

Area of Science:

Geriatric Pharmacology
Medication Safety
Clinical Pharmacy

Background:

Potentially inappropriate medications (PIMs) pose significant risks to the elderly population.
Established criteria like Beers-Fick are used to identify PIMs, but may require adaptation to local contexts.

Purpose of the Study:

To compare the efficacy of the PRISCUS and Beers-Fick criteria in detecting PIMs among elderly patients during their initial outpatient geriatric visit.
To evaluate the applicability of these criteria within the Brazilian pharmacopoeia and healthcare setting.

Main Methods:

A retrospective analysis of medical records was conducted.
The PRISCUS and Beers-Fick criteria, adapted for the Brazilian pharmacopoeia, were applied to identify PIMs in elderly patients at their first geriatric outpatient visit.

Main Results:

The study included elderly patients with a mean age of 77.4 years, consuming an average of 3.9 drugs.
PRISCUS identified more PIMs per patient (0.7) compared to Beers-Fick (0.5), with statistical significance noted for long-acting benzodiazepines and laxatives.
Both criteria failed to account for commonly used substances like vitamins, herbal medications, and eye drops in a notable percentage of cases.

Conclusions:

Both PRISCUS and Beers-Fick are valuable tools for preventing PIMs in the elderly.
The PRISCUS criteria offer a more updated and comprehensive approach.
Neither criterion is fully exhaustive for the Brazilian outpatient medication landscape.