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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

149
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...
149
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

118
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...
118
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

107
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...
107
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

139
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...
139
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

164
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...
164
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

125
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...
125

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Updated: Dec 14, 2025

Improving Strength, Power, Muscle Aerobic Capacity, and Glucose Tolerance through Short-term Progressive Strength Training Among Elderly People
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[Biotherapies in elderly patients].

A Michaut1, S Varin1

  • 1Service de Rhumatologie, Centre Hospitalier Départemental de Vendée, Boulevard Stéphane Moreau, 85000 La Roche-sur-Yon, France.

La Revue De Medecine Interne
|July 18, 2020
PubMed
Summary
This summary is machine-generated.

Biotherapies for autoimmune diseases require careful consideration in elderly patients, focusing on comorbidities rather than age alone. Understanding specific drug contraindications is crucial for safe and effective geriatric treatment.

Keywords:
BiothérapiesEffets secondairesEfficacityEfficacitéElderlySafetySide effectsSujets âgésSécuritébDMARDs

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Area of Science:

  • Rheumatology
  • Geriatrics
  • Immunology

Background:

  • Population aging necessitates evaluating biotherapy safety and efficacy in elderly patients with autoimmune diseases.
  • Current studies are insufficient to address the unique needs and comorbidities of geriatric populations, leading to prescribing hesitancy.
  • Comorbidities, not chronological age, are key factors in determining biotherapy suitability for older adults.

Purpose of the Study:

  • To review adaptations and contraindications of biological disease-modifying anti-rheumatic drugs (bDMARDs) in the geriatric population.
  • To improve the use of bDMARDs in elderly patients, addressing potential undertreatment.
  • To highlight the importance of individualized treatment strategies based on patient-specific factors.

Main Methods:

  • Review of existing literature on bDMARDs in autoimmune diseases among elderly patients.
  • Analysis of contraindications and necessary adaptations for geriatric use.
  • Discussion of clinical reasoning and pedagogical approaches for medical trainees.

Main Results:

  • bDMARDs require careful selection based on individual comorbidities and specific drug profiles.
  • Age alone should not preclude the use of biotherapies; a thorough comorbidity assessment is paramount.
  • Supervision of clinical reasoning in medical students can be enhanced through targeted remediation and accessible educational resources.

Conclusions:

  • Individualized assessment of comorbidities is essential before initiating bDMARDs in elderly patients.
  • Optimizing bDMARD therapy in geriatrics requires a nuanced understanding of drug-specific indications and contraindications.
  • Effective clinical reasoning supervision, supported by resources like MOOCs, is vital for medical education.