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Related Concept Videos

Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

354
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...
354
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

392
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...
392
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

846
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...
846
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

383
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...
383
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

350
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...
350
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

375
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...
375

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Related Experiment Videos

Pre-emptive parecoxib and post-operative cognitive function in elderly patients.

Yue Tian1, Ping Zhao1, Lu Li1

  • 1Department of Anaesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.

International Psychogeriatrics
|September 16, 2014
PubMed
Summary

Pre-emptive administration of parecoxib sodium significantly reduced post-operative cognitive dysfunction (POCD) in elderly patients. This approach also decreased pain medication needs and lowered stress markers.

Keywords:
analgesiacognitive dysfunctioncyclooxygenase-2 inhibitorselderlypost-operative complication

Related Experiment Videos

Area of Science:

  • Anesthesiology
  • Geriatric Medicine
  • Pharmacology

Background:

  • Post-operative cognitive dysfunction (POCD) is a concern in elderly patients undergoing surgery.
  • Investigating pre-emptive analgesia strategies is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of pre-emptive parecoxib sodium in preventing POCD in elderly patients.
  • To assess the impact of parecoxib sodium on stress markers and analgesic requirements.

Main Methods:

  • Elderly patients (65-82 years) with MMSE ≥21 were randomized into control (saline) and parecoxib sodium groups.
  • Parecoxib sodium (40 mg IV) or saline was administered pre-operatively; post-operative pain managed with PCIA (fentanyl, tramadol).
  • Cognitive function (MMSE, neurological tests), plasma cortisol, IL-6, S100β, and analgesic use were monitored.

Main Results:

  • The parecoxib sodium group showed reduced post-operative plasma cortisol levels compared to the control group.
  • Significantly lower fentanyl and tramadol consumption via PCIA was observed in the parecoxib sodium group.
  • The incidence of post-operative cognitive dysfunction (POCD) was notably reduced in patients receiving pre-emptive parecoxib sodium.

Conclusions:

  • Pre-emptive analgesia with 40 mg parecoxib sodium is effective in reducing POCD in elderly surgical patients.
  • Parecoxib sodium may mitigate the stress response and decrease the need for opioid analgesics post-surgery.