Related Experiment Videos
Therapeutic apheresis in the elderly: an update
Emaad M Abdel-Rahman1, Rasheed A Balogun
1Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA.
Journal of Clinical Apheresis
|February 20, 2013
Summary
Therapeutic plasma exchange (TPE) is vital for many conditions. This report highlights special considerations for elderly patients (65+) undergoing TPE, comparing them with younger patient groups.
Area of Science:
- Apheresis Medicine
- Nephrology
- Internal Medicine
Background:
- Therapeutic apheresis, particularly therapeutic plasma exchange (TPE), is a widely used medical procedure.
- TPE treats diverse diseases across multiple organ systems and age groups.
- Elderly patients (≥65 years) represent a growing population requiring TPE.
Purpose of the Study:
- To outline special considerations for TPE in elderly patients.
- To compare TPE practices and outcomes in older versus younger patient cohorts.
- To provide insights based on discussions from the 2012 Therapeutic Apheresis Academy.
Main Methods:
- Review of existing literature and clinical practices regarding TPE in elderly patients.
- Comparative analysis of TPE in patients aged 65 and older versus younger individuals.
- Synthesis of information presented at the Therapeutic Apheresis Academy (September 2012).
Main Results:
- Elderly patients may have unique physiological factors influencing TPE tolerance and efficacy.
- Potential differences in adverse event profiles and management strategies between age groups.
- Specific procedural adjustments or monitoring may be beneficial for older adults.
Conclusions:
- Careful consideration of age-related factors is crucial for optimizing TPE in elderly patients.
- Tailored approaches to TPE in older adults can enhance safety and effectiveness.
- Further research may be warranted to fully elucidate optimal TPE strategies for geriatric populations.
Related Concept Videos
01:15Drug 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...
01:18Pharmacokinetics 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...
01:00Pharmacokinetics 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...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:22Pharmacokinetics 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...
01:27Pharmacodynamics 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...