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Related Concept Videos

Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

131
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...
131
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

157
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...
157
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

120
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...
120
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

172
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...
172
Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

462
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
462
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

129
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...
129

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Antihypertensive medications and physical function in older persons.

Carlos A Vaz Fragoso1, Gail J McAvay2

  • 1VA Connecticut, West Haven, CT, United States of America; Yale School of Medicine, Department of Medicine, New Haven, CT, United States of America.

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Beta blockers and multiple antihypertensives are linked to increased sedentary time in older adults. This finding highlights potential risks associated with these medications in aging populations.

Keywords:
AntihypertensiveDyspneaMobilitySedentarySkeletal muscle

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Area of Science:

  • Gerontology
  • Pharmacology
  • Physical Medicine

Background:

  • Medications can impact physical function in aging populations.
  • Understanding antihypertensive (antiHTN) effects on physical function is crucial.

Purpose of the Study:

  • To evaluate associations between antihypertensive medication class and number used with physical function, mobility, sedentary time, and symptoms in older adults.

Main Methods:

  • Utilized baseline data from the Lifestyle Interventions and Independence in Elder (LIFE) study (N=1567).
  • Employed multivariable models to assess cross-sectional associations of antiHTN class and number with physical measures and symptom questionnaires.
  • Included measures of muscle strength, balance, gait speed, mobility, sedentary time, dyspnea, and fatigue.

Main Results:

  • Nearly 80% of participants used at least one antiHTN medication.
  • Use of beta blockers (BB) was associated with a 44% increased odds of high sedentary time.
  • Using three or more antiHTNs was associated with a 52% increased odds of high sedentary time.

Conclusions:

  • Beta blocker use and polypharmacy with antihypertensives are linked to increased sedentary time in older adults.
  • High sedentary time is a risk factor for adverse health outcomes.
  • Further research is needed to determine if sedentary time modifies antiHTN benefits or risks in aging populations.