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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 Excretion01:18

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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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Cognitive development continues throughout adulthood, undergoing significant shifts across early, middle, and late stages. Individual transition occurs from adolescent idealism to pragmatic and adaptable thinking in early adulthood. During this period, individuals learn to integrate personal beliefs with the recognition that other perspectives are equally valid. Exposure to the complexities of modern society, diverse experiences, and higher education contribute to this adaptive thought process,...
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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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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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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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Selenium status in elderly: relation to cognitive decline.

Bárbara Rita Cardoso1, Verônica Silva Bandeira1, Wilson Jacob-Filho2

  • 1Faculty of Pharmaceutical Sciences, University of São Paulo, Brazil.

Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS)
|September 16, 2014
PubMed
Summary

Low selenium status is linked to cognitive decline in the elderly. This study found lower selenium levels in Alzheimer's patients, suggesting a potential role for selenium deficiency in age-related cognitive impairment.

Keywords:
Alzheimer's diseaseCognitive declineMild cognitive impairmentOxidative stressSelenium

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Area of Science:

  • Biochemistry
  • Neuroscience
  • Gerontology

Background:

  • Decreased antioxidant system function is associated with cognitive decline.
  • Selenium (Se) is an essential trace element with antioxidant properties.
  • Understanding selenium status in neurodegenerative conditions is crucial for public health.

Purpose of the Study:

  • To investigate selenium status in elderly individuals with Alzheimer's disease (AD) and mild cognitive impairment (MCI).
  • To compare selenium levels between AD, MCI, and control groups (CG).
  • To explore the relationship between selenium status and cognitive function in aging populations.

Main Methods:

  • Cross-sectional study involving 27 AD patients, 17 MCI patients, and 28 control elderly individuals.
  • Selenium concentration was measured in plasma and erythrocytes using hydride generation atomic absorption spectroscopy.
  • Cognitive function was assessed to correlate with selenium levels.

Main Results:

  • Erythrocyte selenium concentration was significantly lower in the AD group compared to the CG (p=0.001).
  • Plasma selenium levels were lowest in the AD group compared to both MCI (p=0.000) and CG (p=0.010).
  • A trend of decreasing erythrocyte selenium concentration with declining cognitive function was observed.

Conclusions:

  • Selenium deficiency may contribute to cognitive decline in aging individuals.
  • Erythrocyte selenium levels, reflecting long-term nutritional status, highlight the importance of selenium in maintaining cognitive function.
  • Further research into selenium supplementation for cognitive health is warranted.