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相关概念视频

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

217
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...
217
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

182
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...
182
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

218
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...
218
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

192
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...
192
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

224
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...
224
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

229
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...
229

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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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多药性,多多药性和相关痴呆症:德克萨斯州东南部的一个嵌套病例控制研究.

Jacob Thompson1, Sujin Yu2, Maryam Vasefi3

  • 1Brain and Spine Center of Southeast Texas, Beaumont, TX 77701, United States; Department of Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso, TX 79905, United States.

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
|October 30, 2025
PubMed
概括

多药性,即使用多种药物,显著增加了认知能力下降的风险,包括痴呆症和轻度认知障碍. 较多的药物组与这些疾病的更大概率相关.

关键词:
阿尔茨海默氏症是阿尔茨海默氏症的一种疾病.案件控制 - 案件控制.痴呆症是一种痴呆症.超多元药房 (Hyperpolypharmacy) 是一个多元药房.轻度认知障碍 轻度认知障碍多种药房 多种药房

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科学领域:

  • 神经学 神经学
  • 老年学是指老年学的学科.
  • 临床药理学 临床药理学

背景情况:

  • 多药性是一个日益关注的问题,特别是在老龄化人口中.
  • 以前的研究表明,多种药物和认知衰退之间存在联系,但基于人口的有力的证据是有限的.
  • 了解这些关联对于患者安全和有效的医疗保健至关重要.

研究的目的:

  • 调查多药与认知障碍之间的关联,包括全因痴呆症 (ACD),阿尔茨海默病 (AD) 和轻度认知障碍 (MCI).
  • 确定特定的高风险药物组,这些药物有助于认知能力下降.
  • 检查药物组数和认知结果之间的剂量依赖关系.

主要方法:

  • 使用来自德克萨斯州东南部神经病学实践的电子健康记录,采用了嵌套病例控制研究设计.
  • 数据包括508名ACD患者,149名AD患者,579名MCI患者和730名认知健康对照.
  • 统计分析,包括几率比率 (ORs) 和置信区间 (CI),用于评估认知结果和药物使用之间的关联,控制临床和人口统计变量.

主要成果:

  • 几种药物类别,包括抗精神病药物,抗抑郁药,二氨酸,抗高血压药和多巴胺类药物,与所有认知结果的概率增加显著相关.
  • 皮质类固醇与较高的ACD和AD几率有关,而非二类催眠药和抗药与MCI有关.
  • 在多药和认知障碍之间观察到一种强烈的,剂量依赖的关系. 使用≥10种药物组的个体显着增加了ACD,AD和MCI的几率.

结论:

  • 多药和超多药与所有原因痴呆症,阿尔茨海默病和轻度认知障碍的几率增加有关.
  • 特定的药物组对认知能力下降的风险更高.
  • 对于认知弱势群体来说,定期的药物评估对于减轻与多药学相关的风险至关重要.