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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

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

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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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 Metabolism01:18

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

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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 Distribution01:00

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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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Candidemia in the elderly: What does it change?

Francesco Barchiesi1, Elena Orsetti1, Sara Mazzanti1

  • 1Dipartimento di Scienze Biomediche e Sanità Pubblica, Clinica Malattie Infettive, Università Politecnica delle Marche, Ancona, Italy.

Plos One
|May 12, 2017
PubMed
Summary

Elderly patients with candidemia face higher mortality rates, especially with septic shock or lack of antifungal treatment. This study highlights key risk factors and trends in antifungal resistance in older adults.

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Area of Science:

  • Infectious Diseases
  • Geriatrics
  • Mycology

Background:

  • Candidemia, a life-threatening fungal infection, affects all age groups, but data on elderly patients is limited.
  • Understanding candidemia in older adults is crucial due to potential differences in presentation, comorbidities, and outcomes.

Purpose of the Study:

  • To characterize candidemia in elderly patients (≥65 years) compared to younger adults (18-65 years).
  • To identify risk factors associated with increased mortality in elderly patients with candidemia.

Main Methods:

  • Retrospective study of adult patients diagnosed with candidemia between 2010 and 2015.
  • Comparison of demographics, comorbidities, clinical and microbiological data, antifungal treatment, and outcomes between older and younger patient groups.
  • Analysis of factors associated with 30-day mortality.

Main Results:

  • Elderly patients (188/302) had more frequent comorbidities (e.g., chronic pulmonary disease, cardiovascular disease, diabetes, renal failure) and a higher incidence of septic shock.
  • Thirty-day mortality was significantly higher in older patients (45%) compared to younger patients (28%).
  • Independent predictors of death in the elderly included septic shock and multiple organ failure. A trend towards higher minimum inhibitory concentrations (MICs) for certain antifungal agents was observed.

Conclusions:

  • Elderly patients with candidemia exhibit a significantly higher mortality rate.
  • Lack of antifungal therapy and the presence of septic shock are key contributors to increased mortality in this population.
  • Trends in antifungal resistance warrant further investigation.