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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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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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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...

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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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...

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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Semi-Targeted Ultra-High-Performance Chromatography Coupled to Mass Spectrometry Analysis of Phenolic Metabolites in Plasma of Elderly Adults

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Polypharmacy in Older Adults.

Patricia T Alpert¹, Tricia Gatlin

¹Patricia T. Alpert, DrPH, MSN, APRN, FNP-BC, CNE, FAANP, is the founding Dean at Arizona College, Las Vegas Campus, Las Vegas, Nevada. Tricia Gatlin, PhD, RN, is an Assistant Professor, School of Nursing, University of Nevada Las Vegas, Las Vegas, Nevada.

Home Healthcare Now

|November 4, 2015

Summary

Polypharmacy, the use of multiple medications, poses significant risks for older adults, including adverse effects and falls. This paper explores polypharmacy issues and presents a case study to highlight its importance.

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Area of Science:

Gerontology
Pharmacology
Public Health

Background:

Polypharmacy involves the concurrent use of multiple medications, often within the same class.
It frequently arises in older individuals managing multiple chronic conditions and healthcare providers.

Observation:

Older adults are particularly susceptible to polypharmacy.
Concurrent medication use can stem from treating various chronic conditions.

Findings:

Risks of polypharmacy include increased adverse drug events.
Falls and reduced medication compliance are significant negative outcomes.
Polypharmacy complicates healthcare for elderly patients.

Implications:

Addressing polypharmacy is crucial for improving patient safety in older populations.
Case examples underscore the clinical significance of managing multiple medications.
Strategies to mitigate polypharmacy risks are essential for geriatric care.