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Drug Dosing: Geriatric Patients

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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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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...

Dementia l: Introduction

Dementia l: Introduction

Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

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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 Excretion

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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 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...

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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

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[Delirium and multimorbidity in the elderly].

¹Klinik für Alterspsychiatrie, Psychiatrische Universitätsklinik Zürich. egemen.savaskan@puk.zh.ch

|December 13, 2012

Summary

Delirium, an acute confusion state in elderly patients with multiple health conditions, is often caused by age, dementia, infections, and polypharmacy. Careful assessment and medication review are crucial for managing these complex cases.

Area of Science:

Geriatrics
Internal Medicine
Psychiatry

Context:

Delirium is a common acute confusion state in elderly individuals with multimorbidity.
Key risk factors include advanced age, dementia, infections, and polypharmacy.
Multimorbidity increases the risk of complex disease interactions and medication-related issues, precipitating delirium.

Purpose:

To highlight the multifactorial genesis of delirium in the elderly.
To emphasize the significant risk factors associated with multimorbidity.
To underscore the necessity of thorough assessment and cautious pharmacotherapy in this population.

Summary:

Delirium in the elderly is multifactorial, with age, dementia, infections, and polypharmacy as primary drivers.
Increased disease burden and medication use in multimorbid elderly patients heighten delirium risk.

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Psychiatric conditions like depression, anxiety, and schizophrenia frequently co-occur with somatic diseases.

Impact:

Therapy for elderly multimorbid patients requires comprehensive assessment of all pathogenic factors.
Pharmacotherapy necessitates continuous screening for side effects and appropriate indications.
Improved understanding can lead to better management strategies for delirium in the elderly.