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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

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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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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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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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Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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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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Neuropathic Pain in the Elderly.

Silvia Giovannini1, Daniele Coraci1,2, Fabrizio Brau1,3

  • 1Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.

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Summary
This summary is machine-generated.

Neuropathic pain in older adults, often linked to somatosensory system issues, requires a comprehensive approach. Managing this pain involves medical, social, and psychological support to enhance patient quality of life.

Keywords:
agingneuropathic painpersonalized medicine

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Area of Science:

  • Geriatrics
  • Neurology
  • Pain Management

Background:

  • Neuropathic pain commonly affects the elderly, frequently co-occurring with multiple comorbidities.
  • Elderly patients often undergo polypharmacy, increasing risks of drug interactions and hospital readmissions.
  • Hospitalized elderly patients or those in nursing homes face heightened risks associated with their conditions and treatments.

Purpose of the Study:

  • To underscore the necessity of a multidimensional strategy for managing neuropathic pain in the elderly.
  • To highlight the importance of integrating medical, social, and psychological interventions.
  • To improve the overall quality of life for elderly patients experiencing neuropathic pain and their families.

Main Methods:

  • Review of current literature on neuropathic pain management in geriatric populations.
  • Analysis of challenges associated with polypharmacy and comorbidities in elderly patients.
  • Emphasis on interdisciplinary team collaboration for patient care.

Main Results:

  • Neuropathic pain in the elderly presents unique challenges due to age-related physiological changes and comorbidities.
  • Polypharmacy in this demographic significantly elevates the risk of adverse drug events and hospitalizations.
  • A coordinated, multidimensional care plan is crucial for effective pain management.

Conclusions:

  • Effective management of neuropathic pain in the elderly necessitates a holistic, team-based approach.
  • Integrating medical, social, and psychological support systems is vital for enhancing patient outcomes.
  • Addressing the complex needs of elderly patients with neuropathic pain improves their quality of life and that of their caregivers.