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Drug Dosing: Geriatric Patients

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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 Excretion

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...

Pharmacodynamics in Geriatric Patients: Effects of Age

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...

Clinical Significance of Antibiotic Resistance

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...

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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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Antibiotic concerns in the elderly. A clinician's perspective

¹Boston University School of Medicine, Massachusetts, USA.

Infectious Disease Clinics of North America

|September 1, 1995

Summary

Managing infections in elderly patients presents unique antibiotic challenges. This review covers age-related changes, adherence, and drug interactions for effective empiric therapy.

Area of Science:

Geriatric Medicine
Infectious Diseases
Pharmacology

Background:

Elderly patients exhibit unique physiological changes impacting antibiotic management.
Infections in older adults require careful consideration of multiple complicating factors.

Purpose of the Study:

To review the specific antibiotic concerns in the elderly population.
To highlight challenges in managing infections in geriatric patients.

Main Methods:

Literature review of antibiotic use in elderly patients.
Analysis of age-associated physiological alterations.
Examination of compliance, drug interactions, and adverse drug reactions.

Main Results:

Physiological changes in the elderly affect antibiotic pharmacokinetics and pharmacodynamics.

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Patient compliance and polypharmacy increase the risk of drug-drug interactions.

Adverse drug reactions are more prevalent and potentially severe in older adults.

Conclusions:

Antibiotic selection and management in the elderly require a tailored approach.
Guidelines for empiric therapy must account for the unique vulnerabilities of older patients.
Addressing these concerns is crucial for optimizing infection treatment outcomes in geriatric populations.