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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

278
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...
278
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

239
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...
239
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

263
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...
263
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

222
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...
222
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

257
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...
257
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

712
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...
712

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Updated: Feb 8, 2026

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高齢者におけるアカラシア:包括的概観

Evgenia Mela1, Orestis Lyros2, Vasileios Charalampakis3

  • 1First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, 11527, Athens, Greece. vemela@hotmail.gr.

Digestive diseases and sciences
|February 7, 2026
PubMed
まとめ

アカラシア、食道運動障害は、高齢者で診断されることが増えています。高齢は効果的な治療の障壁ではなく、年齢特異的な管理戦略が必要です。

キーワード:
アカラシア高齢者食道高齢者運動障害

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科学分野:

  • 消化器病学
  • 老年医学
  • 食道運動障害

背景:

  • アカラシアは、食道下部括約筋の弛緩と蠕動運動に影響を与えるまれな食道運動障害です。
  • 世界的な人口高齢化により、高齢者における有病率が増加しています。

研究 の 目的:

  • 高齢者におけるアカラシアの臨床的プレゼンテーション、診断、および管理をレビューすること。
  • アカラシアのプレゼンテーションと転帰における年齢関連の違いを強調すること。

主な方法:

  • 年齢関連の違いのある症状、診断、および治療結果に焦点を当てた文献検索。
  • 高齢者におけるアカラシア管理に関する現在の証拠の分析。

主要な成果:

  • 高齢者患者は、しばしば顕著でない症状、栄養失調/誤嚥の高いリスク、および進行した疾患を呈します。
  • 高解像度マノメトリーは診断のゴールドスタンダードであり、内視鏡検査が先行します。
  • 治療選択肢には、ボツリヌス毒素、空気拡張術、および外科的筋切開術が含まれます。

結論:

  • 進行した年齢は、特に低侵襲オプションでは、確定的なアカラシア治療を妨げるべきではありません。
  • 高齢のアカラシア患者の転帰を最適化するには、エビデンスに基づいた年齢特異的な推奨事項の開発が不可欠です。