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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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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
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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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Potentially Inappropriate Prescription and Its Association with Index Hospitalization: A Multicenter, Cross-Sectional

Gulistan Bahat1, Serdar Ozkok2, Tugba Erdogan2

  • 1Division of Geriatrics, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Capa, 34390, Istanbul, Turkey. gbahatozturk@yahoo.com.

Drugs & Aging
|February 24, 2026
PubMed
Summary
This summary is machine-generated.

Potentially inappropriate prescriptions (PIP) are common in hospitalized older adults, often leading to admission. The Turkish Inappropriate Medication Use in oldEr adults (TIME) criteria effectively identify these issues and missed care opportunities.

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Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Public Health

Background:

  • Potentially inappropriate prescriptions (PIP) are a significant concern in hospitalized older adults.
  • The Turkish Inappropriate Medication Use in oldEr adults (TIME) criteria were developed to assess medication use in this population.

Purpose of the Study:

  • To determine the prevalence and types of PIP in hospitalized older adults.
  • To investigate if PIP contributed to the index hospitalization using TIME criteria.

Main Methods:

  • A multicenter, cross-sectional study involving 405 inpatients aged ≥60 years.
  • PIP assessed using TIME criteria (TIME-to-STOP for PIMs, TIME-to-START for PPOs).
  • Physicians determined if PIMs or PPOs contributed to hospitalization via clinical adjudication.

Main Results:

  • PIP prevalence was 82.5%; 63.2% had PIMs and 71.6% had PPOs.
  • Common PIMs included long-term PPI use without indication; common PPOs included lack of vaccinations.
  • 34.1% of PIP were causally related to hospitalization, with overtreatment of hypertension and lack of nutritional supplements being key factors.

Conclusions:

  • PIP are highly prevalent and a frequent cause of hospitalization in older adults.
  • TIME criteria offer a comprehensive tool for identifying medication-related issues and missed care.
  • Implementing TIME criteria-guided medication reviews could enhance safety and reduce hospitalizations in the elderly.