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Drug Dosing: Geriatric Patients

Drug Dosing: Geriatric Patients

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

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...

Pharmacodynamics in Geriatric Patients: Effects of Age

Pharmacodynamics in Geriatric Patients: Effects of Age

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 Excretion

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

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...

Formulation and Manufacturing Process: Physical Attributes of Generic Tablets and Capsules

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Bioequivalence in generic drugs, such as tablets and capsules, refers to their pharmaceutical equivalence to the brand-name counterparts. However, for therapeutic equivalence, manufacturers must also consider physical attributes like size, shape, and weight (FDA Guidance for Industry, December 2003). Discrepancies in these aspects could impact patient compliance and cause medication errors. For instance, swallowing difficulties, often experienced with larger tablets or capsules, can lead to...

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Relationship between Age and the Ability to Break Scored Tablets.

Kim Notenboom¹, Herman Vromans², Maarten Schipper³

¹Department of Public Health Effects, National Institute for Public Health and the EnvironmentBilthoven, Netherlands; CBG, Medicines Evaluation BoardUtrecht, Netherlands.

Frontiers in Pharmacology

|August 11, 2016

Summary

Older adults struggle more with breaking scored tablets by hand compared to younger adults. This difficulty impacts medication adherence and requires healthcare provider assessment for appropriate use.

Keywords:

age comparative study older adults score line tablet breaking

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Area of Science:

Gerontology
Pharmaceutical Sciences
Patient Adherence

Background:

Difficulties in breaking scored tablets by hand can lead to medication non-adherence.
Impaired manual dexterity in older adults, often due to age-related conditions, may exacerbate tablet-breaking challenges.
The prevalence of tablet-breaking difficulties among the elderly population is not well-understood.

Purpose of the Study:

To investigate the relationship between age and the ability to successfully break scored tablets.
To compare the tablet-breaking performance of older adults with that of younger adults.

Main Methods:

A comparative study involving 36 older adults and 36 young adults.
Participants attempted to break 12 different types of scored tablets using three distinct manual techniques.
Outcomes measured included successful breaking and accuracy of the break.

Main Results:

Older adults successfully broke significantly fewer tablets (38.1%) compared to young adults (78.2%).
The accuracy of breaking tablets was similar between the two age groups (71.0% for older adults vs. 77.4% for young adults).
Age was identified as a significant factor associated with the ability to break tablets, but not the accuracy.

Conclusions:

Manual breaking of scored tablets is less effective in older adults than in younger adults.
Healthcare providers should consider patients' abilities when prescribing medications that require tablet breaking.
Assessment of a patient's capacity to break tablets and provision of proper instructions are crucial if tablet splitting is necessary.