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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

327
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...
327
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

284
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...
284
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

299
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...
299
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

273
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...
273
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

288
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...
288
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

765
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...
765

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Clinical Alerts to Decrease High-Risk Medication Use in Older Adults.

Wilhelmina Lord-Adem, Nicole J Brandt

    Journal of Gerontological Nursing
    |June 27, 2017
    PubMed
    Summary

    Clinical alert systems can reduce high-risk medication (HRM) use in older adults, improving patient safety and decreasing adverse drug events (ADEs). This review examines HRM alert systems, their impact on prescribing, and implementation challenges.

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    Area of Science:

    • Gerontology
    • Health Informatics
    • Pharmacology

    Background:

    • High-risk medications (HRMs) are prevalent in older adults, contributing to over 50% of adverse drug events (ADEs).
    • HRM-related ADEs increase morbidity, mortality, hospitalizations, and healthcare costs.
    • Information technology, specifically clinical alert systems, shows promise in mitigating these issues.

    Purpose of the Study:

    • To identify and discuss clinical alert systems for high-risk medications (HRMs).
    • To evaluate the impact of these systems on prescribing patterns in older adults.
    • To explore challenges associated with implementing electronic decision support systems.

    Main Methods:

    • Literature review of clinical alert systems targeting HRMs.
    • Analysis of studies on the impact of these systems on prescribing for older adults.
    • Discussion of implementation barriers for electronic decision support.

    Main Results:

    • Clinical alert systems are effective in decreasing HRM use in older populations.
    • These systems contribute to improved patient safety by reducing ADEs.
    • Implementation challenges include system integration, user adoption, and workflow disruption.

    Conclusions:

    • Clinical alert systems are a valuable tool for reducing HRM use and enhancing patient safety in older adults.
    • Addressing implementation challenges is crucial for widespread adoption and maximizing benefits.
    • Further research is needed to optimize electronic decision support for geriatric pharmacotherapy.