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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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Hypertension I: Introduction01:28

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Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
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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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Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

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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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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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[Hypertension in the elderly: What we need to know].

P Fernández-Llama1, N Ayasreh1, F Calero1

  • 1Unidad de Hipertensión y Prevención de Daño Renal, Servicio de Nefrología, Fundació Puigvert, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau, Barcelona, España.

Hipertension Y Riesgo Vascular
|November 26, 2020
PubMed
Summary

Hypertension affects over two-thirds of adults over 65, presenting unique management challenges. Effective treatment in the elderly significantly reduces cardiovascular risks and overall mortality.

Keywords:
Hipertensión sistólica aisladaHipotensión ortostáticaIsolated systolic hypertensionOrthostatic hypotensionRigidez vascular y fragilidadVascular stifness and fragility

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Area of Science:

  • Geriatric Medicine
  • Cardiovascular Health
  • Internal Medicine

Background:

  • Hypertension prevalence exceeds two-thirds in individuals over 65.
  • Comorbidities contribute to a heterogeneous elderly population regarding functional capacity.
  • Aging-related vascular stiffness leads to specific hypertension types, such as isolated systolic hypertension.

Purpose of the Study:

  • To highlight the unique characteristics of hypertension in the elderly.
  • To emphasize factors influencing blood pressure measurement in older adults.
  • To underscore the importance of considering these factors in therapeutic decision-making.

Main Methods:

  • Clinical blood pressure measurement.
  • Consideration of temporal, environmental, and positional influences on blood pressure.
  • Review of evidence regarding hypertension management in the elderly.

Main Results:

  • Elderly hypertension management is complicated by factors like isolated systolic hypertension and vascular stiffness.
  • Blood pressure readings are influenced by circadian rhythms (e.g., absence of night dipping), the white coat phenomenon, and postural changes (orthostatic hypotension).
  • Evidence supports that treating hypertension in this age group reduces cardiovascular morbidity and mortality, as well as all-cause mortality.

Conclusions:

  • Specialized considerations are necessary for evaluating and managing hypertension in the elderly.
  • Accounting for various influences on blood pressure is crucial for effective therapeutic strategies.
  • Treatment of hypertension in older adults is associated with significant reductions in adverse health outcomes.