Influence of Ageing on the Pharmacodynamics and Pharmacokinetics of Chronically Administered Medicines in Geriatric Patients: A Review

Clinical Pharmacokinetics, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 11, 2025

As people age, the efficiency of various regulatory processes that ensure proper communication between cells and organs tends to decline. This deterioration can lead difficulties in maintaining homeostasis during physiological stress. includes but is not limited cognitive impairments, functional difficulties, issues related caregivers which contribute significantly medication errors non-adherence. These factors higher morbidity, extended hospital stays, reduced quality life, even mortality. The decrease homeostatic capacity varies among individuals, contributing greater variability observed geriatric populations. Significant pharmacokinetic pharmacodynamic alterations accompany ageing. Pharmacokinetic changes include decreased renal hepatic clearance an increased volume distribution for lipid-soluble drugs, prolong their elimination half-life. Pharmacodynamic typically involve sensitivity drug classes, such as anticoagulants, antidiabetic psychotropic medications. review examines primary age-related geriatrics impact on pharmacokinetics pharmacodynamics

Language: Английский

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Risk of falls associated with non-GABAergic hypnotics and benzodiazepines in hospitalized patients

General Hospital Psychiatry, Journal Year: 2025, Volume and Issue: 94, P. 10 - 15

Published: Feb. 13, 2025

Language: Английский

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Factors influencing aging in high-income countries

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 23 - 34

Published: Feb. 1, 2025

Abstract Aging is a critical issue for families, policymakers, healthcare providers, and society at large. This chapter explores the biological, environmental, behavioural, psychosocial factors that influence experience of aging in high-income countries. Age-related decline, emergence chronic disease, social isolation, functional changes occur context urbanization, population shifts, limitations workforce among other factors. Responses to include programmes support informal carers, implementation integrated models healthcare, mitigation impact health well-being. In parallel ideas age-related concepts positive emphasize independence minimize disability also countries, although these benefits security are unequally experienced due differential exposure environments promote well-being or illness. Therapies disease policies bolster poorly resourced decrease harmful exposures need be implemented within framework equity.

Language: Английский

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Secular Trends in Central Nervous System-Active Polypharmacy Among Serial Cross-Sections of US Adults, 2009–2020

Drugs & Aging, Journal Year: 2023, Volume and Issue: 40(10), P. 941 - 951

Published: Sept. 11, 2023

Language: Английский

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Association between Opioid-Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries

Published: April 18, 2024

Background/Objectives: Concurrent opioid (OPI) and benzodiazepine (BZD) use may exacerbate falls/fractures risk compared to no or alone. Yet, patients need concurrent OPI-BZD for co-occurring conditions (e.g., pain anxiety). Therefore, we examined the association between longitudinal dosing patterns subsequent injurious falls risk. Methods: We conducted a retrospective cohort study including non-cancer fee-for-service Medicare beneficiaries initiating OPI and/or BZD in 2016-2018. identified during 3 months following initiation (i.e., trajectory period) using group-based multi-trajectory models. estimated time first fall within post-trajectory period inverse-probability-of-treatment-weighted Cox proportional hazards Results: Among 622,588 (age≥65=84.6%, female=58.1%, White=82.7%; having falls=0.45%), 13 distinct trajectories: Group(A):Very-low OPI-only (early discontinuation)(44.9% of cohort); (B):Low (rapid decline)(15.1%); (C):Very-low (late discontinuation)(7.7%); (D):Low (gradual decline)(4.0%); (E):Moderate decline)(2.3%); (F):Very-low BZD-only discontinuation)(11.5%); (G):Low decline)(4.5%); (H):Low (stable) (3.1%); (I):Moderate decline)(2.1%); (J):Very-low decline)/Very-low discontinuation)(2.9%); (K):Very-low (increasing)(0.9%); (L):Very-low (stable)/Low (stable)(0.6%); (M):Low decline)/Low decline)(0.6%). Compared with Group(A), 6 trajectories had increased 3-month risks: (C): HR, 95%CI=1.78, 1.58-2.01; (D): 2.24, 1.93-2.59; (E): 2.60, 2.18-3.09; (H): 2.02, 1.70-2.40; (L): 2.73, 1.98-3.76; (M): 1.96, 1.32-2.91. Conclusions: Our findings suggest that varied across trajectories, highlighting importance considering both dose duration when assessing risks among older adults.

Language: Английский

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Association between Central Nervous System Drugs and Femoral Fracture Risk in Japanese Individuals ≥80 Years Old: A Case-crossover Study

Internal Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 1, 2024

Objectives To assess the association between concomitant use of central nervous system drugs and femoral fracture risk in individuals ≥80 years old Japan.

Language: Английский

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Association between Opioid–Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(12), P. 3376 - 3376

Published: June 7, 2024

Background/Objectives: Concurrent opioid (OPI) and benzodiazepine (BZD) use may exacerbate injurious fall risk (e.g., falls fractures) compared to no or alone. Yet, patients need concurrent OPI-BZD for co-occurring conditions pain anxiety). Therefore, we examined the association between longitudinal dosing patterns subsequent risk. Methods: We conducted a retrospective cohort study including non-cancer fee-for-service Medicare beneficiaries initiating OPI and/or BZD in 2016–2018. identified during 3 months following initiation (i.e., trajectory period) using group-based multi-trajectory models. estimated time first within 3-month post-trajectory period inverse-probability-of-treatment-weighted Cox proportional hazards Results: Among 622,588 (age ≥ 65 = 84.6%, female 58.1%, White 82.7%; having 0.45%), 13 distinct trajectories: Group (A): Very-low OPI-only (early discontinuation) (44.9% of cohort); (B): Low (rapid decline) (15.1%); (C): (late (7.7%); (D): (gradual (4.0%); (E): Moderate (2.3%); (F): BZD-only (11.5%); (G): (4.5%); (H): (stable) (3.1%); (I): (2.1%); (J): decline)/Very-low (2.9%); (K): (increasing) (0.9%); (L): (stable)/Low (0.6%); (M): decline)/Low (0.6%). Compared with (A), six trajectories had an increased risk: HR 1.78, 95% CI 1.58–2.01; 2.24, 1.93–2.59; 2.60, 2.18–3.09; 2.02, 1.70–2.40; 2.73, 1.98–3.76; 1.96, 1.32–2.91. Conclusions: Our findings suggest that varied across trajectories, highlighting importance considering both dose duration when assessing among older adults.

Language: Английский

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Management of delirium in acute stroke patients: a position paper by the Austrian Stroke Society on prevention, diagnosis, and treatment

Therapeutic Advances in Neurological Disorders, Journal Year: 2024, Volume and Issue: 17

Published: Jan. 1, 2024

Delirium is a common complication in acute stroke patients, occurring 15-35% of all unit admissions and associated with prolonged hospital stay poor post-stroke prognosis. Managing delirium patients necessitates an intensive multiprofessional therapeutic approach, placing significant burden on healthcare staff. However, dedicated practical recommendations for management developed the population are lacking. For this purpose, Austrian Stroke Society, cooperation Society Neurology, Neurorehabilitation, Psychiatry, Psychotherapy, Psychosomatics has formulated evidence-based position paper addressing patients. The outlines three pillars care delirium: (a) Key aspects

Language: Английский

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Use of Benzodiazepines in Women’s Health

The Journal for Nurse Practitioners, Journal Year: 2024, Volume and Issue: 20(10), P. 105199 - 105199

Published: Nov. 1, 2024

Language: Английский

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The use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers may relate to the survival and walking ability in geriatric patients with hip fractures: a 1-year follow-up study

BMC Musculoskeletal Disorders, Journal Year: 2023, Volume and Issue: 24(1)

Published: March 28, 2023

Many elder patients with hip fractures also suffered from hypertension. This study aims to explore the relationship between use of ACEI or ARB and outcomes geriatric fractures.All were divided into four groups: non-users without hypertension, users, users. The in different groups compared. LASSO regression univariable Cox analysis used for variable screening. Then models Logistics established identify relationships RAAS inhibitors outcomes.ACER users (p = 0.016) 0.027) had a significantly lower survival probability than Non-users may face 6-month 1-year mortalities higher free walking rates compared hypertension.Patients better prognosis fractures.

Language: Английский

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