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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 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 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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

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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

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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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Medication Use by Older Adults with Frailty: A Scoping Review.

Rishabh Sharma1, Tanaya Sharma1, Brent McCready-Branch1

  • 1School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, ON N2G 1C5, Canada.

Pharmacy (Basel, Switzerland)
|November 24, 2025
PubMed
Summary

Medication use significantly increases health risks for frail older adults. This review found high rates of polypharmacy and potentially inappropriate medications (PIMs) in this vulnerable population.

Keywords:
frailtyolder adultspolypharmacypotentially inappropriate medication

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Area of Science:

  • Gerontology
  • Pharmacology
  • Public Health

Background:

  • Frailty in older adults is a significant risk factor for adverse health outcomes.
  • Medication use is a major contributor to the vulnerability of frail individuals.

Purpose of the Study:

  • To explore medication use patterns in older adults with frailty within primary care settings.
  • To investigate the prevalence of potentially inappropriate medications (PIMs), polypharmacy, and medication adherence.
  • To understand the role of medication use in adverse drug events among frail older adults.

Main Methods:

  • A scoping review was conducted following Arksey and O'Malley guidelines, supplemented by PRISMA-ScR.
  • Literature searches were performed in major databases (EMBASE, PubMed, Scopus, CINAHL, International Pharmaceutical Abstracts) up to November 2023.
  • Included studies focused on older adults (≥65 years) with frailty, assessing medication use.

Main Results:

  • 223 studies from 39 countries were included, with frailty prevalence ranging from 0.9% to 89.2%.
  • Polypharmacy (5-9 medications) and hyper-polypharmacy (≥10 medications) were highly prevalent, with rates from 1.3% to 96.4%.
  • Potentially inappropriate medication (PIM) prevalence varied widely, from 2.4% to 95.9%.

Conclusions:

  • Medication use, including polypharmacy and PIMs, presents significant challenges for frail older adults.
  • Further research is needed to fully understand the complex relationship between medication management and frailty.
  • Interventions targeting medication use in frail older adults are crucial for improving health outcomes.