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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

274
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...
274
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

238
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...
238
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

261
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...
261
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

217
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...
217
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

255
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...
255
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

701
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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Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
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Emergency Department Wait Times for Geriatric Psychiatric Patients.

Laura Lai1, Robert G Bota2,1

  • 1Department of Psychiatry, UC Irvine Health Neuropsychiatric Center, University of California, Irvine, California, USA.

The Primary Care Companion for CNS Disorders
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Summary

Older adults needing psychiatric care often face long waits in the emergency department (ED) due to a shortage of specialized geriatric facilities. This study quantified ED wait times for these vulnerable patients.

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Area of Science:

  • Geriatric Psychiatry
  • Emergency Medicine
  • Healthcare Access

Background:

  • Older adults with complex conditions like Alzheimer's disease require specialized geriatric psychiatric facilities for inpatient care.
  • A shortage of these specialized facilities leads to prolonged emergency department (ED) stays for patients awaiting bed availability.

Purpose of the Study:

  • To quantify the wait times experienced by older adults in the ED when psychiatric hospitalization is needed.
  • To understand the duration of ED stays for geriatric psychiatric patients.

Main Methods:

  • Retrospective review of patient records for individuals aged 60-89 years who received psychiatric consultations in the ED over a two-year period.
  • Calculation of total mean time spent in the ED from check-in to discharge.

Main Results:

  • The average age of patients was 66.67 years.
  • Dementia and neurocognitive disorders were the most frequent reasons for geriatric psychiatry referrals.
  • Patients recommended for admission spent over 24 hours in the ED, while those recommended for discharge averaged 13 hours.

Conclusions:

  • Findings highlight significant delays in care for older adults with psychiatric needs within the ED setting.
  • There is a critical need for improved assessment, care, and increased availability of specialized geriatric psychiatric services.