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Related Concept Videos

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

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...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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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...
377
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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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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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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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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Colistin nephrotoxicity increases with age.

Ilker Inanc Balkan1, Mustafa Dogan, Bulent Durdu

  • 1From the 1 Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa School of Medicine , Istanbul.

Scandinavian Journal of Infectious Diseases
|July 31, 2014
PubMed
Summary
This summary is machine-generated.

Colistin (COL) use for resistant infections can cause acute kidney injury (AKI). Older patients (over 60) and those with lower initial kidney function or high comorbidity scores are at higher risk for COL-induced AKI.

Keywords:
Colistinagenephrotoxicity

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Colistin (COL) is crucial for treating infections caused by extensively drug-resistant (XDR) Gram-negative bacteria.
  • Acute kidney injury (AKI) is a primary limitation to colistin therapy.
  • Understanding risk factors for COL-induced AKI is essential for patient safety.

Purpose of the Study:

  • To identify risk factors for new-onset AKI in patients treated with intravenous colistin.
  • To analyze the incidence and severity of AKI based on RIFLE criteria.
  • To determine predictors of AKI in a cohort receiving colistin.

Main Methods:

  • Retrospective cohort study involving 198 adult patients treated with intravenous COL for ≥72 hours.
  • Comparison of patients with and without pre-existing kidney dysfunction.
  • Logistic regression analysis to identify risk factors for AKI.

Main Results:

  • New-onset AKI developed in 46.1% of patients, with 21% classified as failure.
  • Older age (over 60 years) was the major predictor of AKI (OR 5.199).
  • High Charlson Comorbidity Index (CCI) scores and low initial estimated glomerular filtration rate (GFR) were also associated with increased AKI risk.

Conclusions:

  • Colistin-induced nephrotoxicity is significantly more common in patients over 60 years old.
  • Low initial GFR and high CCI scores, often age-related, contribute to AKI risk.
  • Age is a critical factor in predicting colistin-induced AKI.