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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

269
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...
269
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

259
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...
259
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

215
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...
215
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

253
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...
253
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

701
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...
701
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

235
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...
235

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Identifying and Resolving Drug-Related Problems in Geriatric Patients.

Meghan E Peterson1, Joanna L Stollings1, E Wesley Ely1,2

  • 1Vanderbilt University Medical Center, Nashville, TN, USA.

Hospital Pharmacy
|January 30, 2026
PubMed
Summary
This summary is machine-generated.

Geriatric patients face high risks for drug therapy problems due to aging changes and multimorbidity. A multidisciplinary team approach involving pharmacists, physicians, and advanced practice providers (APPs) is crucial for optimizing medication management and patient safety.

Keywords:
adverse drug reactionsgeriatricsphysician prescribing

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Area of Science:

  • Gerontology
  • Clinical Pharmacy
  • Internal Medicine

Background:

  • Aging leads to physiological changes, affecting drug responses and increasing geriatric patients' risk for drug-related problems.
  • Multimorbidity and polypharmacy are common in older adults, complicating medication regimens and adherence.
  • Drug therapy problems in geriatric patients include inappropriate medication use and adherence issues, often exacerbated by complex regimens and costs.

Purpose of the Study:

  • To describe key physiological changes associated with aging in geriatric patients.
  • To highlight the essential roles of pharmacists, physicians, and advanced practice providers (APPs) in managing geriatric pharmacotherapy.
  • To discuss methods for assessing and optimizing drug therapy regimens for older adults.

Main Methods:

  • Review of geriatric physiological changes impacting drug therapy.
  • Exploration of the multidisciplinary team's role (pharmacists, physicians, APPs) in addressing drug therapy problems.
  • Discussion of assessment tools like the American Geriatric Society Beers Criteria and Screening Tool of Older Persons' Prescriptions (STOPP) / Screening Tool to Alert to Right Treatment (START).

Main Results:

  • Geriatric patients are at high risk for drug-related problems due to age-related changes and multimorbidity.
  • A collaborative approach across the care continuum is vital for successful drug therapy management.
  • Pharmacists, physicians, and APPs must actively identify, assess, and resolve drug therapy problems.

Conclusions:

  • Optimizing drug therapy in geriatric patients requires a coordinated, multidisciplinary effort.
  • Routine medication assessment, reconciliation, deprescribing, and adherence support are key strategies.
  • Utilizing evidence-based tools aids in appropriate medication selection and prevention of prescribing cascades.