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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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

Pharmacodynamics in Geriatric Patients: Effects of Age

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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 not...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

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...
Dosage Regimen: Individualization01:24

Dosage Regimen: Individualization

Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...

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Related Experiment Video

Updated: Jul 5, 2026

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

Identification of Potentially Inappropriate Medications for Adults Below 65 Years: Protocol for a Modified Delphi

Eva Filosa1, Nicole Schönenberger2,3, Utibe R Essien4

  • 1Division of Clinical and Translational Research, Faculty of Medicine and Health Sciences, McGill University, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada, 1 (514) 934-1934 ext 36134.

JMIR Research Protocols
|July 3, 2026
PubMed
Summary

This study developed an international list of potentially inappropriate medications (PIMs) for adults aged 18-65. This aims to improve medication safety and deprescribing for non-elderly populations.

Keywords:
Delphi techniqueadult populationconsensus developmentdeprescribingmedication appropriatenesspolypharmacypotentially inappropriate medicationsstudy protocol

Related Experiment Videos

Last Updated: Jul 5, 2026

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

Area of Science:

  • Pharmacology
  • Medication Safety
  • Clinical Pharmacy

Background:

  • Polypharmacy and potentially inappropriate medications (PIMs) are common, leading to adverse events and increased healthcare costs.
  • Existing PIM criteria and deprescribing guidelines primarily focus on older adults, neglecting younger populations.
  • There's a critical need for medication safety guidance for adults aged 18-65.

Purpose of the Study:

  • To develop an international consensus-based list of PIMs for adults aged 18 to 65 years.
  • To address a gap in medication safety and deprescribing guidance for non-geriatric adult populations.
  • To inform the development of international guidelines for safer prescribing and deprescribing.

Main Methods:

  • A modified Delphi process involving an international, interdisciplinary panel of 30-40 experts.
  • A preliminary list of PIMs was developed via literature review and expert input.
  • Three survey rounds were used to rate PIM relevance based on benefit-harm balance, patient preferences, and alternatives, with consensus defined by specific rating and agreement thresholds.

Main Results:

  • Panel recruitment included 36 participants between September-October 2025.
  • Three data collection rounds were completed between October 2025-January 2026.
  • Final data analysis is ongoing, with consensus results anticipated in late 2026.

Conclusions:

  • The Delphi process will generate a consensus list of PIMs for adults aged 18-65.
  • This list will support the creation of international guidelines for medication safety.
  • Deprescribing efforts will be expanded to include younger adult populations.