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Related Concept Videos

Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

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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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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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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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Pharmacogenetics and Pharmacogenomics: Overview01:29

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Pharmacogenetics and pharmacogenomics examine how genetic factors influence an individual's response to drugs. While pharmacogenetics focuses on the impact of specific genetic variants on drug effects, pharmacogenomics takes a broader approach, studying how genetic variation across populations contributes to differences in drug responses. These fields aim to explain why individuals may experience varying levels of efficacy or adverse reactions to the same medication.Variability in drug...
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Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu01:29

Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu

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Genetic variations significantly influence drug response through pharmacokinetics, receptor interactions, and biologic milieu modifications. Pharmacokinetic alterations impact drug metabolism and clearance, affecting efficacy and toxicity. Variants in drug-metabolizing enzymes, such as CYP2C9 and CYP2C19, alter drug activation and elimination. For example, CYP2C9 loss-of-function variants require lower warfarin doses to prevent excessive bleeding, while CYP2C19 variants reduce clopidogrel...
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Pharmacogenetics of Drug Metabolism: Overview01:27

Pharmacogenetics of Drug Metabolism: Overview

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Genetic polymorphism in drug metabolism is crucial to the inter-individual variability observed in drug responses. Drug metabolism primarily involves the chemical modification of drugs and other xenobiotics to enhance their elimination by increasing their polarity. Two main classes of enzymes mediate this biotransformation process: Phase I enzymes, primarily cytochrome P450s, catalyze oxidation and reduction reactions, while other enzymes, such as esterases, mediate hydrolysis, and Phase II...
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Measuring pharmacogenetics in special groups: geriatrics.

Davide Seripa1, Francesco Panza, Julia Daragjati

  • 1IRCCS Casa Sollievo della Sofferenza, Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences , San Giovanni Rotondo, Foggia , Italy dseripa@operapadrepio.it.

Expert Opinion on Drug Metabolism & Toxicology
|May 21, 2015
PubMed
Summary
This summary is machine-generated.

Cytochrome P450 (CYP) drug metabolism may decrease with age due to epigenetic changes. This age-related decrease in CYP gene expression could explain increased adverse drug reactions and therapeutic failures in older adults.

Keywords:
CYPDNA methylationepigeneticsgeriatricspharmacogenetics

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Area of Science:

  • Pharmacogenetics
  • Epigenetics
  • Geriatric Medicine

Background:

  • Cytochrome P450 (CYP) enzymes metabolize approximately 80% of common drugs.
  • Older patients exhibit a higher incidence of adverse drug reactions (ADRs) and therapeutic failures (TFs).
  • Investigating age-related changes in CYP metabolism is crucial for understanding geriatric drug response.

Purpose of the Study:

  • To review CYP pharmacogenetics, focusing on epigenetic regulation by DNA methylation in aging.
  • To explore how age-related epigenetic modifications influence CYP gene expression and drug metabolism.

Main Methods:

  • Comprehensive literature review of CYP pharmacogenetics.
  • Focus on DNA methylation as an epigenetic mechanism regulating CYP genes.
  • Analysis of age-related changes in DNA methylation patterns.

Main Results:

  • Age-related physiological changes in DNA methylation can alter gene expression.
  • A decrease in CYP gene expression is observed with advancing age.
  • This decrease may contribute to increased ADRs and TFs in the elderly.

Conclusions:

  • CYP genetics forms the basis of drug response phenotypes, modulated by environmental and physiological factors.
  • Age-related epigenetic changes, specifically DNA methylation, lead to reduced CYP gene expression.
  • Geriatrics represents a unique population for pharmacogenetic studies due to age-related metabolic alterations.