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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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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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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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Endoscopic Procedures II: Colonoscopy01:25

Endoscopic Procedures II: Colonoscopy

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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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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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

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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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Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
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Colorectal Cancer Screening in the Elderly.

Andrea L Betesh1, Felice H Schnoll-Sussman2

  • 1Department of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY 10021, USA.

Clinics in Geriatric Medicine
|November 20, 2020
PubMed
Summary
This summary is machine-generated.

Colorectal cancer (CRC) screening is recommended for those aged 50-75. For individuals over 75, the benefits of CRC screening may not outweigh the risks due to increased comorbidities and decreased life expectancy.

Keywords:
Colon cancerColonoscopyColorectal cancerElderlyScreeningShared decision-making

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Area of Science:

  • Oncology
  • Preventive Medicine
  • Geriatrics

Background:

  • Colorectal cancer (CRC) is a significant and preventable malignancy.
  • Routine screening is advised for average-risk individuals aged 50-75, effectively reducing CRC incidence and mortality.
  • The established age cutoff for screening may not adequately address individual health variations.

Purpose of the Study:

  • To evaluate the shifting risk-benefit ratio of continued colorectal cancer screening in individuals over 75 years of age.
  • To explore the limitations of fixed age cutoffs in guiding personalized screening decisions for older adults.
  • To consider the impact of increasing comorbidities and decreasing life expectancy on the efficacy of CRC prevention strategies in the elderly.

Main Methods:

  • Review of existing literature on colorectal cancer screening guidelines and outcomes.
  • Analysis of risk factors, including age, comorbidities, and life expectancy, in the context of screening.
  • Examination of the potential complications associated with colorectal cancer screening procedures.

Main Results:

  • The risk-benefit balance for colorectal cancer screening changes significantly after age 75.
  • Increased comorbidities and reduced life expectancy in older individuals diminish the future benefits of CRC prevention.
  • Screening carries a growing risk of complications in the elderly population.

Conclusions:

  • Fixed age cutoffs for colorectal cancer screening are insufficient for making individualized decisions in patients over 75.
  • Personalized risk-benefit assessments are crucial for determining the appropriateness of continued screening in older adults.
  • Physiological heterogeneity among individuals necessitates a tailored approach to colorectal cancer screening beyond age 75.