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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 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 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 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 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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Comprehensive Geriatric Assessment by Primary Care Pharmacists.

Kerry Wilbur1, Anuoluwapo F Awotunde1, Jennifer Bolt1,2,3

  • 1Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada.

Journal of Applied Gerontology : the Official Journal of the Southern Gerontological Society
|November 10, 2025
PubMed
Summary

Pharmacists can enhance geriatric care by using practical tools for comprehensive geriatric assessment (CGA) beyond medication review. This study identified evidence-based assessment tools suitable for community and primary care settings.

Keywords:
communitycomprehensive geriatric assessmentinterprofessional carepharmacy

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Area of Science:

  • Gerontology
  • Primary Care Medicine
  • Pharmaceutical Sciences

Background:

  • Interprofessional collaboration is vital for optimizing care in older adults.
  • Comprehensive geriatric assessment (CGA) is challenging in primary care due to limited team-based infrastructure.
  • Pharmacists are accessible and have longitudinal patient relationships, positioning them to support CGA.

Purpose of the Study:

  • To identify practical, evidence-based tools for pharmacists to conduct comprehensive geriatric assessment (CGA).
  • To assess pharmacist-led CGA domains including functional ability, mobility, cognition, and social support.
  • To explore patient and professional perspectives on tools for geriatric care.

Main Methods:

  • A modified Delphi process involving a multidisciplinary panel, including patient partners.
  • Tools were rated for importance on a seven-point scale, with consensus defined as ≥75% agreement.
  • Analysis focused on tool conciseness, response options, and alignment with patient preferences.

Main Results:

  • Highly rated tools were concise with nuanced response options, suitable for pharmacist-led CGA.
  • Patient partners' preferences aligned with health professionals' ratings, emphasizing personalization.
  • Barriers to referral and follow-up within primary care settings were identified.

Conclusions:

  • Pharmacists can effectively contribute to comprehensive geriatric assessment (CGA) using identified tools.
  • Accessible, multidisciplinary pathways are needed to integrate pharmacist-led CGA into primary care.
  • Findings provide actionable opportunities for pharmacists to improve geriatric care outcomes.