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Related Concept Videos

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

49
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 Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

41
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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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Related Experiment Video

Updated: Nov 5, 2025

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Readmission Rates Associated with Pharmacist Involvement in a Geriatric Transitional Care Management Clinic.

E Jared McPhail1, Vincent D Marshall1, Tami L Remington1

  • 1University of Michigan College of Pharmacy.

Innovations in Pharmacy
|May 19, 2021
PubMed
Summary
This summary is machine-generated.

A pharmacist telephone call in transitional care management (TCM) did not significantly reduce 30-day hospital readmissions for older adults. However, the full TCM service, including a pharmacist, nurse navigator, and primary care provider (PCP) visit, significantly lowered 90-day readmissions.

Keywords:
geriatricinterdisciplinarypatient centered medical homepharmacisttransitional care management

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Area of Science:

  • Geriatric Medicine
  • Health Services Research
  • Pharmacy Practice

Background:

  • Transitional care management (TCM) aims to reduce hospital readmissions for vulnerable patient populations.
  • Geriatric patients often face complex health needs post-discharge, increasing readmission risks.
  • The role of pharmacists within interdisciplinary TCM teams is an area of ongoing investigation.

Purpose of the Study:

  • To assess the effect of post-discharge pharmacist telephone calls on 30- and 90-day readmission rates.
  • To evaluate the impact of a comprehensive TCM service within a geriatric patient-centered medical home (PCMH).
  • To compare readmission rates between patients receiving different components of the TCM service.

Main Methods:

  • A retrospective analysis of 513 hospital discharges of patients aged 60 years and older from a PCMH.
  • Comparison of 30- and 90-day readmission rates for patients who received a pharmacist TCM call versus those who did not.
  • Secondary analysis compared patients receiving the full TCM service (pharmacist, nurse navigator, PCP) with those receiving only nurse navigator and PCP services.

Main Results:

  • Pharmacist TCM calls were associated with a non-significant trend toward lower 30-day readmissions (8.9% vs. 12.7%, P=0.17).
  • No significant difference in 30-day readmissions was observed when comparing the full TCM service to nurse navigator/PCP services alone (7.9% vs. 10.6%, P=0.49).
  • Patients receiving the full TCM service demonstrated significantly fewer 90-day readmissions compared to those without pharmacist contact (16.3% vs. 31.8%, P=0.01).

Conclusions:

  • Pharmacist telephone interventions within TCM did not significantly impact 30-day readmissions.
  • A comprehensive TCM service including pharmacist, nurse navigator, and PCP visits significantly reduced 90-day readmissions.
  • Further research is warranted to identify optimal patient selection and strategies to enhance participation in TCM services.