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

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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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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

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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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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...
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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...
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Oral Health Assessment by Lay Personnel for Older Adults
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Educational needs, practice patterns and quality indicators to improve geriatric pharmacy care.

Dan Zou1, Cara Tannenbaum1

  • 1Faculties of Pharmacy (Zou, Tannenbaum) and Medicine (Tannenbaum), Université de Montréal, Montréal, Quebec.

Canadian Pharmacists Journal : CPJ = Revue Des Pharmaciens Du Canada : RPC
|March 25, 2014
PubMed
Summary

Pharmacists need more geriatric pharmacotherapy education to improve prescribing safety and reduce hospitalizations in older adults. Continuing education in the workplace is key for better drug outcomes in the elderly.

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Area of Science:

  • Geriatric pharmacotherapy
  • Pharmacy practice
  • Medication safety

Background:

  • Growing elderly population necessitates pharmacists' shared responsibility for safe prescribing.
  • Increasing pressure to reduce adverse drug reactions and hospitalizations in older adults.

Purpose of the Study:

  • To assess educational needs and practice patterns of pharmacists in geriatric care.
  • To identify factors influencing pharmacist performance in geriatric pharmacotherapy.

Main Methods:

  • Cross-sectional postal survey of 3927 hospital and community pharmacists in Québec.
  • Assessed awareness of geriatric pharmacotherapy issues and familiarity with Beers criteria.
  • Used univariate logistic regression to determine modifiable factors for higher performance.

Main Results:

  • 18% response rate (706 pharmacists).
  • Less than 50% aware of polypharmacy, inappropriate prescribing, or drug-related hospitalizations in the elderly.
  • Familiarity with Beers criteria and workplace continuing education significantly increased screening for inappropriate prescriptions.
  • Pharmacists had time for detailed reviews in only 30% of older patients.
  • Tracking hospitalizations and monitoring inappropriate prescriptions were key quality indicators.

Conclusions:

  • Workplace continuing education in geriatric pharmacotherapy is the most significant factor for improving pharmacist performance.
  • Enhanced education is crucial for pharmacists to effectively manage medications in the elderly and improve drug outcomes.