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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

286
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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Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

333
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

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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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Nephrotic Syndrome III : Nursing Management01:24

Nephrotic Syndrome III : Nursing Management

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Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

271
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...
271

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Related Experiment Videos

Managing Gout Flares in the Elderly: Practical Considerations.

Abhishek Abhishek1,2

  • 1Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK. Abhishek.abhishek@nottingham.ac.uk.

Drugs & Aging
|December 8, 2017
PubMed
Summary

Gout management in the elderly is complex due to comorbidities and polypharmacy. Arhalofenate shows promise for gout flares and hyperuricemia, but requires further study in older adults.

Related Experiment Videos

Area of Science:

  • Rheumatology
  • Geriatrics
  • Pharmacology

Background:

  • Gout is prevalent in individuals over 60, with increasing incidence and altered presentation in the elderly.
  • Older adults often have comorbidities and polypharmacy, complicating gout flare management.
  • Gout in the elderly may present with joint system involvement, systemic effects, and tophi.

Purpose of the Study:

  • To review the challenges and therapeutic options for managing gout in the elderly population.
  • To evaluate the potential role of arhalofenate in treating gout flares and hyperuricemia in older adults.
  • To discuss the implications of comorbidities and polypharmacy on gout treatment strategies for the elderly.

Main Methods:

  • Literature review of gout epidemiology, pathophysiology, and treatment guidelines in the elderly.
  • Analysis of current treatment modalities, including intra-articular corticosteroids, oral prednisolone, and xanthine oxidase inhibitors (XOI).
  • Evaluation of emerging therapies like arhalofenate, considering its mechanism, efficacy, and safety profile in the context of elderly patients.

Main Results:

  • Intra-articular corticosteroids are preferred for accessible joints; oral prednisolone is favored over low-dose colchicine; NSAIDs should be avoided.
  • Xanthine oxidase inhibitors (XOI) are first-line for hyperuricemia.
  • Arhalofenate may help prevent flares and lower urate but needs further study in the elderly and those with chronic kidney disease.

Conclusions:

  • Gout management in the elderly requires careful consideration of comorbidities, polypharmacy, and drug interactions.
  • Arhalofenate presents a potential new option for gout flare prophylaxis and urate reduction, particularly when other treatments are contraindicated.
  • Further research is essential to establish the safety and efficacy of arhalofenate in the elderly population and in patients with chronic kidney disease.