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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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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

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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...
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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

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

174
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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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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Acromegaly in the elderly patients.

Maria Rosaria Ambrosio1, Irene Gagliardi1, Sabrina Chiloiro2

  • 1Section of Endocrinology & Internal Medicine, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy.

Endocrine
|February 16, 2020
PubMed
Summary

Acromegaly management is evolving, with more elderly patients being diagnosed. This review highlights the need for tailored approaches for older individuals with growth hormone excess, considering their unique needs and potential complications.

Keywords:
AcromegalyComorbiditiesDiagnosisElderlyEpidemiologyManagement

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Area of Science:

  • Endocrinology
  • Geriatric Medicine

Background:

  • Acromegaly results from excess growth hormone (GH) and insulin-like growth factor-1 (IGF-1), often due to pituitary adenomas.
  • Untreated GH excess causes serious systemic complications and increased mortality.
  • Improved management has increased patient lifespan, leading to a growing elderly acromegaly population.

Purpose of the Study:

  • To review the epidemiology, diagnosis, clinical presentation, complications, and management of acromegaly in elderly patients.
  • To identify specific considerations for managing acromegaly in older adults.

Main Methods:

  • Literature search of PubMed database up to August 2019 using relevant keywords.
  • Assessment of available studies focusing on elderly patients with acromegaly.

Main Results:

  • Data on acromegaly in the elderly are limited but suggest significant differences compared to younger patients.
  • Increased prevalence of pituitary incidentalomas due to advanced imaging contributes to elderly diagnoses.

Conclusions:

  • Acromegaly in the elderly presents unique challenges requiring specialized attention.
  • Further comparative studies are essential to develop personalized diagnostic and therapeutic strategies for elderly acromegaly patients.