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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 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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Pulmonary Tuberculosis I

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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
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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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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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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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Aging with HIV: multimorbidity and polypharmacy burden.

Nazife Duygu Demirbas1, Husrev Diktas2, Ozlem Gul1

  • 1Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.

AIDS Care
|October 13, 2025
PubMed
Summary

Older people living with HIV (PLWH) face higher rates of multiple health conditions and polypharmacy. This study highlights the need for tailored care strategies to manage these complex health needs in aging PLWH.

Keywords:
Drug–drug interactionsHIV and agingMultimorbidityNon-communicable diseasesOlder adults living with HIVPolypharmacySDG 3: good health and well-Being

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Area of Science:

  • Geriatric Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Aging individuals living with HIV (PLWH) are increasingly recognized as a population at elevated risk for multimorbidity and polypharmacy.
  • These conditions present significant challenges in managing the healthcare needs of older PLWH on antiretroviral therapy (ART).

Purpose of the Study:

  • To determine the prevalence of multimorbidity and polypharmacy in elderly PLWH compared to their HIV-negative counterparts.
  • To identify risk factors associated with multimorbidity and polypharmacy in this demographic.

Main Methods:

  • A cross-sectional study design was employed, comparing PLWH aged 50 and older with age- and sex-matched controls without HIV.
  • Logistic regression analysis was utilized to pinpoint independent predictors of polypharmacy.

Main Results:

  • Multimorbidity was more prevalent in PLWH (29%) than controls (22%), with significantly higher rates of osteoporosis and psychiatric disorders.
  • Polypharmacy (≥5 non-ART medications) was also more frequent in PLWH (20.4% vs. 11.8%).
  • Independent predictors of polypharmacy included HIV status, increasing age, and lack of formal education. Drug-drug interactions were common, particularly among those with polypharmacy.

Conclusions:

  • Older PLWH exhibit a greater burden of multimorbidity and polypharmacy compared to HIV-negative individuals.
  • Implementing targeted interventions, including medication reviews, drug interaction monitoring, and preventive care, is crucial for improving health outcomes in this aging population.