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Related Concept Videos

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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Drug Dosing: Geriatric Patients01:15

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

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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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The Effect of Aging on Tissues01:19

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Several body functions deteriorate with age. The external signs of aging are easily identifiable. For example, the skin becomes dry, less elastic, and thins out, forming wrinkles. The skin of the face begins to appear looser due to a decrease in the levels of elastic and collagen fibers in the connective tissue. Additionally, melanin production in the hair follicle decreases with age, resulting in gray hair. Moreover, the senses of sight and hearing decline, so glasses and hearing aids may...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

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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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Modic Change: An Emerging Complication in the Aging Population.

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  • 1Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.

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Lower back pain (LBP) is often linked to Modic changes (MC) in the spine. Understanding MC

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Area of Science:

  • Spinal imaging and biomechanics
  • Musculoskeletal disorders
  • Pain management

Background:

  • Vertebral endplates are crucial for spinal stability and nutrition but are prone to mechanical failure.
  • Endplate degeneration, often initiating disk degeneration, manifests as Modic changes (MC) on MRI.
  • Modic changes represent subchondral bone marrow alterations visible on magnetic resonance imaging.

Purpose of the Study:

  • To review the pathogenesis, prevalence, clinical associations, diagnostic methods, and treatments for lower back pain (LBP) associated with Modic changes (MC).
  • To synthesize current knowledge on the etiology and management of LBP with MC.

Main Methods:

  • A comprehensive literature review was performed.
  • The review focused on the history, etiology, risk factors, diagnostic modalities, and treatment of LBP with MC.

Main Results:

  • Modic changes (MC) are classified into three types: Type 1 (edema), Type 2 (fatty replacement), and Type 3 (sclerosis).
  • Type 1 MC is associated with inflammation and severe LBP, while Types 2 and 3 are generally more stable.
  • Proposed etiologies for MC include autoimmunity, mechanical stress, infection, and genetic factors.

Conclusions:

  • Modic changes (MC) are increasingly prevalent, particularly in aging populations.
  • Understanding MC pathogenesis is vital for developing preventative and therapeutic strategies, including rehabilitation and various interventions.
  • Improved diagnostic accuracy for MC is crucial for timely intervention and functional recovery in patients with lower back pain.