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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

289
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...
289
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

253
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...
253
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

272
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...
272
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

265
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...
265
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

741
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...
741
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

242
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...
242

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Updated: Feb 19, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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The Need for Medication Reconciliation Increases with Age.

Rima Rappaport1,2, Zeev Arinzon1,2, Jacob Feldman1,2

  • 1Department of Geriatric Medicine, Meir Medical Center, Kfar Saba, Israel.

The Israel Medical Association Journal : IMAJ
|November 6, 2017
PubMed
Summary

Medication reconciliation (MR) identified significant discrepancies between prescribed and actual drug use in 82% of elderly patients. This highlights the critical need for MR to ensure patient safety and prevent adverse drug events.

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Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Patient Safety

Background:

  • Medication reconciliation (MR) is a mandated hospital practice to minimize adverse drug events.
  • Elderly patients are particularly vulnerable to medication-related complications.

Purpose of the Study:

  • To conduct medication reconciliation in elderly patients admitted to the hospital.
  • To identify factors contributing to discrepancies between prescribed medications and actual consumption.

Main Methods:

  • Study included patients aged 65 years and older admitted to the hospital on at least one prescription medication.
  • Medication evaluation and recording performed within 24 hours of admission for 94% of patients.

Main Results:

  • 82% of patients exhibited discrepancies between primary care physician (PCP) prescriptions and real medication use (RMU).
  • Cardiovascular drugs were most frequently mismatched in PCP lists (39%), while alimentary tract/metabolism drugs were most mismatched in RMU (36%).
  • Discrepancies involved one drug in 67% of cases; mismatching was more prevalent in females (85%) than males (46%).

Conclusions:

  • Medication reconciliation processes reveal significant differences between drug prescriptions and actual patient use.
  • MR holds substantial potential for identifying clinically significant medication discrepancies in all hospitalized patients.
  • Addressing these discrepancies is crucial for improving medication safety in the elderly.