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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

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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 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 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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Exploring Fall-Related Fracture Risk by Possible Fall-Risk Increasing Drugs in Japanese Older Adults Using Municipal

Hiroya Nakano1, Masao Iwagami2,3, Jun Komiyama2,3

  • 1Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Geriatrics & Gerontology International
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Certain medications, including antipsychotics and NSAIDs, increase fracture risk in older adults. Careful prescription of these drugs is crucial for fall prevention in the elderly.

Keywords:
drug safetyfall‐related fracturesfall‐risk‐increasing drugspharmacoepidemiologyreal‐world data

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Area of Science:

  • Gerontology
  • Pharmacology
  • Public Health

Background:

  • Falls are a major cause of fractures in older adults.
  • Medications, particularly fall-risk-increasing drugs (FRIDs), are potential contributors to falls and subsequent fractures.
  • Understanding the specific drug associations is vital for risk mitigation strategies.

Purpose of the Study:

  • To investigate the association between the use of fall-risk-increasing drugs (FRIDs) and other medications and the risk of fall-related fractures.
  • To differentiate risks associated with long-term versus short-term medication use.

Main Methods:

  • Utilized linked medical and long-term care insurance claims data from Japanese community-dwelling older adults (2014-2019).
  • Employed a nested case-control study for long-term use and a case-crossover study for short-term use.
  • Defined non-vertebral fractures and analyzed medication exposure using conditional logistic regression to calculate odds ratios (ORs).

Main Results:

  • Long-term use of calcium channel blockers and anti-dementia drugs showed significantly elevated fracture risk (ORs: 1.16 and 1.62, respectively).
  • Short-term use of antipsychotics, opioids, anticonvulsants, and NSAIDs also demonstrated significantly increased fracture risk (ORs: 3.65, 1.53, 1.86, and 1.46, respectively).

Conclusions:

  • Both long-term and short-term use of specific medications are significantly associated with an increased risk of fractures in older adults.
  • Clinical attention to the prescription of these identified drugs in the elderly population is warranted to reduce fracture incidence.