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Drug Dosing: Geriatric Patients01:15

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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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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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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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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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Potentially Suboptimal Prescribing for Older First Nations Peoples: A Scoping Review.

Nicola Franks1,2, Karl McDermott1,2, Karen Carlisle1

  • 1College of Medicine and Dentistry, James Cook University College of Medicine and Dentistry, Cairns, Queensland, Australia.

Australasian Journal on Ageing
|January 12, 2026
PubMed
Summary

Potentially suboptimal prescribing, especially prescribing omissions, significantly impacts the health of older First Nations Peoples globally. Addressing these issues is crucial for improving health equity and closing the gap in care.

Keywords:
First Nation Peoplesagedinappropriate prescribingpolypharmacy

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Area of Science:

  • Pharmacology and Geriatric Medicine
  • Indigenous Health Research
  • Health Equity Studies

Background:

  • Older First Nations Peoples face unique health challenges.
  • Appropriate prescribing is vital for managing chronic conditions in this demographic.
  • Existing literature on prescribing practices for this population is fragmented.

Purpose of the Study:

  • To review current literature on appropriate prescribing for older First Nations Peoples.
  • To identify factors contributing to potentially suboptimal prescribing.
  • To understand the impact of prescribing practices on morbidity and mortality.

Main Methods:

  • A scoping review of electronic databases and grey literature.
  • Inclusion criteria focused on First Nations Peoples aged 45+ in Australia, USA, Canada, and New Zealand.
  • Literature examined holistic and suboptimal prescribing concepts.

Main Results:

  • Sixteen articles were analyzed, revealing heterogeneity in findings.
  • Prescribing omissions were identified as having a significant impact on morbidity and mortality.
  • Risk factors for suboptimal prescribing included regionality, comorbidities, disease states, and residential care facility (RACF) living.

Conclusions:

  • Potentially suboptimal prescribing is a significant international concern for First Nations Peoples.
  • Addressing prescribing omissions is essential for improving health outcomes.
  • This review highlights the need for culturally appropriate and equitable prescribing strategies.