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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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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 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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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 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...
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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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Chronic polypharmacy at all age: A population-based drug utilization study.

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Chronic polypharmacy, defined as using five or more long-term medications, affects 5.6% of the French population. This study highlights its prevalence across all ages and evolving drug patterns with age.

Keywords:
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Area of Science:

  • Pharmacology
  • Public Health
  • Epidemiology

Background:

  • Polypharmacy is a growing concern, often narrowly defined by age.
  • Understanding chronic polypharmacy across diverse age groups is crucial for public health.
  • This study addresses the need for a comprehensive description of chronic polypharmacy in France, irrespective of age.

Purpose of the Study:

  • To describe the prevalence and incidence of chronic polypharmacy in the French population.
  • To analyze the age-specific prevalence of chronic polypharmacy.
  • To identify the main drug classes involved in chronic polypharmacy and their age-related patterns.

Main Methods:

  • A cross-sectional descriptive study utilizing a representative sample (1/97th) of the French health insurance database (EGB).
  • Inclusion of all subjects alive and covered by French healthcare insurance in 2015.
  • Definition of chronic polypharmacy as the use of five or more drugs daily for over six months.

Main Results:

  • In 2015, 5.6% of 584,862 subjects exhibited chronic polypharmacy (incidence 1.1%).
  • Prevalence increased significantly with age, peaking at 29.2% in the 80-90 age group.
  • Lipid-modifying agents were most frequent (10%), followed by cardiovascular and nervous system drugs, with age-related variations.

Conclusions:

  • Chronic polypharmacy is prevalent across the French population, not limited to older adults.
  • Drug utilization patterns in chronic polypharmacy evolve significantly with age.
  • Findings underscore the need for age-inclusive strategies to manage polypharmacy.