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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

244
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...
244
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 Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

730
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...
730
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 Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

235
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...
235

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Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
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Oncologic considerations in the elderly.

Mohamed K Kamel1, Jeffrey L Port

  • 1Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Weill Cornell Medicine- New York Presbyterian Hospital, New York, USA.

Current Opinion in Anaesthesiology
|November 10, 2017
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Summary
This summary is machine-generated.

Surgical resection of lung cancer is safe for elderly patients. Tailoring procedures to individual performance status and utilizing minimally invasive techniques can improve outcomes, challenging the notion that age alone prohibits curative treatment.

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Area of Science:

  • Thoracic surgery
  • Geriatric oncology
  • Surgical oncology

Background:

  • Elderly patients with thoracic malignancies are often undertreated due to perceived high risks.
  • Presumptions of high morbidity and mortality associated with treatment in this demographic are common.

Purpose of the Study:

  • To review current practices and recent advancements in the surgical management of thoracic malignancies in elderly patients.
  • To address the specific challenges and outcomes of lung cancer surgery in the aged population.

Main Methods:

  • Review of current literature on surgical management of thoracic malignancies in the elderly.
  • Analysis of outcomes associated with different surgical approaches and patient characteristics.

Main Results:

  • Lung resections are generally safe in elderly patients with lung cancer.
  • Lobectomy is recommended for early-stage disease in patients with good performance status.
  • Minimally invasive approaches (VATS, robotic surgery) offer improved outcomes and lower morbidity compared to thoracotomy.
  • Limited resections are a viable option for patients with significant comorbidities.
  • Multidisciplinary tumor board discussion is advised for major resections in advanced-stage disease.

Conclusions:

  • Surgical resection is a safe and effective option for elderly patients with thoracic malignancies.
  • Age should not be a barrier to curative surgical treatment.
  • Surgical strategies must be individualized based on patient performance status and comorbidities.