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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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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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Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

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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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Antipsychotic drugs primarily block dopamine and serotonin receptors and cholinergic, adrenergic, and histaminergic receptors, thereby reducing hallucinations and delusions in conditions like schizophrenia. However, they can trigger unwanted extrapyramidal effects such as dystonias, Parkinson-like symptoms, and tardive dyskinesia.
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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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Atypical antipsychotics in the elderly.

S Beck Carol Paton Rafael Euba Cait Goddard

    International Journal of Psychiatry in Clinical Practice
    |June 13, 2014
    PubMed
    Summary
    This summary is machine-generated.

    Atypical antipsychotics are frequently prescribed for elderly dementia patients, despite limited evidence of effectiveness and safety. Side effect monitoring may be insufficient in clinical practice.

    Keywords:
    Elderly Antipsychotic Atypical Dementia

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    Area of Science:

    • Geriatric Psychiatry
    • Clinical Pharmacology

    Background:

    • Antipsychotics are commonly used for behavioral disturbances in elderly dementia patients.
    • Use of these drugs in the elderly is controversial due to poor evidence of efficacy and tolerability.
    • Atypical antipsychotics have fewer extrapyramidal side effects than older drugs in younger adults.

    Purpose of the Study:

    • To determine the prevalence of atypical antipsychotic prescribing in elderly psychiatric patients.
    • To identify the indications for atypical antipsychotic use in this population.
    • To assess documented side effects associated with atypical antipsychotic use.

    Main Methods:

    • A cross-sectional study screening medication cards of elderly psychiatric patients (over 65).
    • Data collected from 19 Trusts over one week in March 2000.
    • Information gathered by pharmacists from clinical notes.

    Main Results:

    • Half of patients prescribed antipsychotics received an atypical agent.
    • Risperidone was the most commonly prescribed atypical antipsychotic.
    • Half of the study sample had a dementia diagnosis; documented side effects were uncommon.

    Conclusions:

    • Atypical antipsychotics are frequently prescribed as first-line treatment for dementia-related behavioral problems.
    • There is a poor evidence base for the efficacy and safety of these drugs in the elderly.
    • Inadequate monitoring of side effects remains a potential issue.