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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...
287
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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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...
299
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

282
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...
282
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

272
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...
272
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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[Sepsis : particularities in the elderly patients].

Xavier Roux1, Benedikt Huttner2, Jérôme Pugin3

  • 1Service de médecine interne et réhabilitation, Département de médecine interne, réhabilitation et gériatrie, site des Trois-Chêne, HUG, 1211 Genève 14.

Revue Medicale Suisse
|July 12, 2017
PubMed
Summary

Diagnosing sepsis in elderly patients is challenging due to variable symptoms. New 2016 definitions and prompt treatment are crucial for better outcomes in this vulnerable population.

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Area of Science:

  • Gerontology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Sepsis, a life-threatening organ dysfunction from infection, presents variably in the elderly, complicating diagnosis.
  • Aging-related pathophysiological changes heighten the risk of rapid deterioration to septic shock in older adults.

Purpose of the Study:

  • To highlight the challenges in diagnosing sepsis in the elderly.
  • To emphasize the importance of new sepsis definitions and timely treatment initiation.
  • To guide physicians on managing sepsis in older adults, considering age-specific factors.

Main Methods:

  • Review of the 2016 sepsis definitions.
  • Analysis of clinical presentation variability in elderly sepsis patients.
  • Consideration of age-specific factors in treatment and intensive care unit admission decisions.

Main Results:

  • The 2016 sepsis definitions, based on objective scores, aim for earlier recognition.
  • Prompt treatment is vital due to increased risk of sudden deterioration in the elderly.
  • Management requires adherence to guidelines while accounting for comorbidities and care objectives.

Conclusions:

  • Sepsis diagnosis in the elderly requires careful consideration of variable presentations.
  • New definitions and rapid intervention are key for improving sepsis outcomes in older adults.
  • Personalized management, including assessment of comorbidities and care goals, is essential for elderly sepsis patients.