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Related Concept Videos

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

193
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...
193
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...
145
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

170
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...
170
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

142
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...
142
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

150
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...
150
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

172
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...
172

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Intracellular Phosphoflow Cytometry of Acute Myeloid Leukemia Patient-Derived Xenotransplants
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CML in Elderly: Does Age Matter?

Kadabur Nagendrappa Lokesh1, Jitendra Kumar Pehalajani1, Dassappa Loknatha1

  • 1Department of Medical Oncology, Kidwai Cancer Institute, Marigowda Road, Bangalore, 560029 India.

Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion
|March 17, 2020
PubMed
Summary
This summary is machine-generated.

Elderly patients with chronic myeloid leukemia (CML) in India show similar outcomes to younger patients when treated with tyrosine kinase inhibitors (TKIs). While some toxicities were more frequent in older adults, their overall prognosis remained comparable.

Keywords:
Chronic myeloid leukemiaTyrosine kinase inhibitorsMajor molecular response

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Area of Science:

  • Hematology
  • Oncology
  • Clinical Medicine

Background:

  • Chronic myeloid leukemia (CML) median age of diagnosis in India (35 years) is younger than in Western populations (47 years).
  • Outcomes for elderly CML patients in India, particularly in the tyrosine kinase inhibitor (TKI) era, are underreported.
  • Western literature suggests TKIs mitigate age-related adverse effects on CML outcomes.

Purpose of the Study:

  • To analyze the clinical profile and treatment outcomes of elderly CML patients compared to younger patients in India.
  • To evaluate the efficacy and safety of TKIs in elderly CML patients within the Indian population.

Main Methods:

  • Retrospective analysis of 712 CML patients treated between January 2008 and December 2017.
  • Patients were divided into two groups: elderly (≥60 years, n=52) and younger (18-60 years, n=660).
  • Data collected included clinical history, responses (hematological, molecular), and toxicity profiles.

Main Results:

  • Elderly patients had a higher prevalence of co-morbidities (15.3% vs. 4.5%) but similar high-risk EUTOS scores.
  • Rates of hematological response at 3 months (85.1% vs. 86.89%) and major molecular response at 18 months (54.3% vs. 60.16%) were comparable between groups.
  • Elderly patients experienced higher rates of hematological toxicity, muscle cramps, and gastritis, though not significantly worse overall.

Conclusions:

  • The outcomes for CML patients treated with TKIs do not significantly differ between elderly and younger populations in India.
  • Elderly CML patients may experience increased specific toxicities, but overall treatment toxicity is not significantly inferior.
  • TKIs appear effective in managing CML in the elderly Indian population, similar to younger patients.