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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

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 Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

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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...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

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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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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

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...
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Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Atherosclerosis III: Management01:26

Atherosclerosis III: Management

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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Related Experiment Video

Updated: May 2, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

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Managing moderate-to-severe psoriasis in the elderly.

Nicola Balato1, Cataldo Patruno, Maddalena Napolitano

  • 1Department of Dermatology, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy.

Drugs & Aging
|February 21, 2014
PubMed
Summary

Treating elderly psoriasis patients requires careful consideration of health conditions and medications. Physicians must adjust doses for kidney function and monitor side effects, especially with biologics, due to increased infection risks.

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Area of Science:

  • Dermatology
  • Geriatric Medicine
  • Pharmacology

Background:

  • Psoriasis management in the elderly presents unique challenges due to comorbidities, polypharmacy, and organ function decline.
  • Topical treatments are first-line for limited psoriasis; phototherapy is an option for those unsuitable for systemic agents.
  • Age-related pharmacokinetic changes, particularly reduced kidney function, necessitate dose adjustments for systemic psoriasis therapies.

Purpose of the Study:

  • To review the challenges and considerations for managing psoriasis in elderly patients.
  • To discuss the safety and efficacy of various psoriasis treatments in geriatric populations.
  • To highlight the importance of individualized treatment plans considering comorbidities and organ function.

Main Methods:

  • Review of current literature on psoriasis treatment in the elderly.
  • Analysis of pharmacokinetic alterations and drug interactions in older adults.
  • Evaluation of safety data for systemic and biologic agents in geriatric patients.

Main Results:

  • Topical agents and phototherapy are preferred first-line treatments.
  • Systemic agents like methotrexate and acitretin require dose adjustments and careful monitoring (renal function, lipids, liver enzymes).
  • Biologics, including anti-tumor necrosis factor (TNF)-α agents, carry an infection risk, necessitating caution in the elderly, though etanercept may be better tolerated.

Conclusions:

  • Psoriasis treatment in the elderly demands a cautious, individualized approach.
  • Physicians must carefully weigh the risks and benefits of systemic and biologic therapies.
  • Further research is needed to establish the long-term safety of biologics in the geriatric population.