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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

229
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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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

193
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...
193
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

235
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...
235
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

203
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...
203
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

245
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...
245
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

259
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...
259

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Geriatrics 5Ms for Primary Care Workshop.

Sarah C Phillips1,2,3, Chelsea E Hawley4,5, Laura K Triantafylidis6

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Summary

A Geriatrics 5Ms workshop improved primary care residents' self-efficacy in caring for older adults. This innovative training enhanced knowledge of geriatric competencies and point-of-care tools for an aging population.

Keywords:
DementiaDeprescribingElderlyFallsGeriatricsPrimary CarePrognosis

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Area of Science:

  • Geriatric Medicine
  • Medical Education

Background:

  • The Geriatrics 5Ms framework offers a novel approach to older adult care.
  • This framework aligns with Accreditation Council for Graduate Medical Education (ACGME) core competencies for internal and family medicine residents.

Purpose of the Study:

  • To assess the impact of a Geriatrics 5Ms workshop on primary care residents' self-efficacy and knowledge.
  • To evaluate an innovative method for teaching geriatrics to residents.

Main Methods:

  • A half-day Geriatrics 5Ms workshop was developed using Kern's six-step curriculum development approach.
  • The workshop utilized interactive modules and point-of-care tools focused on a longitudinal patient case.
  • Piloted with 33 internal medicine residents.

Main Results:

  • High resident satisfaction with the workshop and its point-of-care tools (cognitive assessment, prognosticating, deprescribing).
  • 75% of workshop participants reported high self-efficacy in Geriatrics 5Ms domains, compared to 40% of controls.
  • Significant improvement in self-efficacy compared to pre-workshop assessment (20%).

Conclusions:

  • The Geriatrics 5Ms workshop effectively improved primary care residents' self-efficacy and knowledge.
  • This training method efficiently prepares residents to care for the aging population, meeting ACGME geriatric competencies.