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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 Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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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...
35
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

491
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
491
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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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

38
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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GH Replacement in the Elderly: Is It Worth It?

Silvia Ricci Bitti1, Marta Franco1, Manuela Albertelli1,2

  • 1Endocrinology Unit, Department of Internal Medicine and Medical Specialties, School of Medical and Pharmaceutical Sciences, University of Genova, Genova, Italy.

Frontiers in Endocrinology
|July 2, 2021
PubMed
Summary
This summary is machine-generated.

Growth hormone (GH) replacement therapy may improve quality of life and cardiovascular health in elderly patients with GH deficiency (EGHD). However, more research is needed to confirm long-term benefits and address treatment costs.

Keywords:
GHD diagnosisIGF-1elderlygrowth hormonegrowth hormone deficiency (GDH)growth hormone replacement therapy

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Area of Science:

  • Endocrinology
  • Geriatrics
  • Metabolism

Background:

  • Growth hormone (GH) is vital for adult metabolism, affecting muscle, cardiovascular, and bone health.
  • GH deficiency (GHD) in the elderly (EGHD) is linked to reduced quality of life (QoL), increased cardiovascular risk, and frailty.
  • While GH replacement therapy (GHrt) shows promise in adults (AGHD), its efficacy and safety in EGHD require further investigation.

Purpose of the Study:

  • To review current data on GH replacement therapy (GHrt) in elderly patients with GH deficiency (EGHD).
  • To evaluate the strengths and weaknesses of GHrt in this population.
  • To provide clinical guidance for managing EGHD.

Main Methods:

  • Mini-review of existing literature on GH replacement therapy in elderly patients with GH deficiency.
  • Synthesis of data regarding effects on body composition, cardiovascular risk factors, bone metabolism, and quality of life.
  • Analysis of limitations, including lack of randomized controlled trials and cost-effectiveness considerations.

Main Results:

  • GHrt in AGHD suggests improvements in lean/fat mass, blood pressure, lipid profile, bone metabolism, and QoL.
  • Evidence for similar benefits in EGHD is less robust, with a scarcity of randomized controlled trials.
  • Concerns regarding long-term mortality outcomes and the cost of GHrt impact treatment decisions.

Conclusions:

  • GH replacement therapy warrants consideration for elderly patients with GH deficiency, potentially improving QoL and metabolic parameters.
  • Further high-quality, long-term studies, including randomized controlled trials, are essential to establish definitive benefits and optimal use in EGHD.
  • Clinical decision-making should balance potential benefits against evidence limitations and treatment costs.