Geriatrics Populations

Respiratory Syncytial Virus. Respiratory syncytial vims (RSV) causes severe lower respiratory tract disease in infants. It is the major cause of hospitalization in the United States (- 90,000 events/yr) and it has a high mortaUty rate in neonates and other high risk populations, such as the geriatric population (51). Development of an RSV vaccine has always been a major priority, however, earlier attempts have mostiy failed (70). 

In summary, the steadily increasing size of geriatric populations in developed countries and the resultant increases in age-related diseases of the brain have provided the impetus for intensive study of the processes underlying neurodegeneration. A better understanding of these processes will likely lead to better methods of treatment not only for progressive memory disorders such as Alzheimer disease, but also for motor disorders such as amyotrophic lateral sclerosis, and cerebrovascular disorders such as stroke. 

The majority of the information discussed to this point and most of the literature concerned with drug absorption involve studies performed in young, healthy (usually male) adults. In contrast, there is considerably less information concerning absorption in subjects at either end of the age spectrum (i.e., pediatric and geriatric populations). For a variety of reasons, one would expect the absorption process in the latter... 

Finally, drug absorption and excretion have not been evaluated in pediatric or geriatric populations. However, here again the tolerability of rifaximin in childhood and in the elderly has found to be extremely good [33]. 

Ouslander JG, Shih YT, Malone-Lee J, and Luber K. Overactive bladder Special considerations in the geriatric population. Am J Manag Care 2000 6 S599-S606. 

Treatment of patient groups with specific sociodemographic or medical characteristics (geriatric populations, patients suffering from comorbidity, e.g. HIV, renal or hepatic impairment, diabetes). 

Because of increased responsiveness to all these drugs, dosage should usually be started at a fraction of that used in young adults. The half-lives of some phenothiazines are increased in the geriatric population. Thioridazine s half-life, for example, is more than doubled. Plasma protein binding of fluphenazine is reduced, which results in an increase of the free drug total drug ratio. 

Aspirin, especially when used chronically in geriatric populations, is known for its side effects of GI discomfort and bleeding. Therefore, serum salicylate levels with regular and enteric-coated aspirin were compared in volunteers in a chronic disease hospital and residential home for the elderly [42], It was found that there was no significant difference between the blood levels reached with conventional... 

Although appropriate studies on the relationship of age to the effects of potassium-sparing diuretics have not been performed in the geriatric population, the elderly may be at an increased risk of developing hyperkalemia. In addition, elderly patients are more likely to have age-related renal function impairments, which may require caution in patients receiving potassium-sparing diuretics. 

These studies are often performed in special patient populations not previously studied (for example, pediatric or geriatric populations). Here, modeling and simulation is applied to guide dose selection in these populations. 

Poisoning in the geriatric population is an ongoing public health concern. In the majority of patients older than 64 years of age, accidental poisoning due to dementia and confusion, improper use or storage of a product, and therapeutic errors is the rule. However, approximately one in 10 is intentional with suicidal intent. Interestingly, elderly females are approximately three times more likely to commit suicide with drugs than males (who prefer carbon monoxide). 

Moore, S., Jones, J. (1985). Adverse drug reaction surveillance in the geriatric population A preliminary review. In S. Moore T. Teal (Eds.), Geriatric drug use—Clinical and social perspectives (pp. 70-77). New York Pergamon. 

The geriatric population is arbitrarily defined as comprising patients 65 years or older. The older the population likely to use the drug, the more important it is... 

SSRI-induced hyponatremia is unusual in non-geriatric populations, but the chlorprothixene may have played a role in this case. 

The role of different types of benzodiazepines in the risk of falls in a hospitalized geriatric population has been examined in a prospective study of 7908 patients, consecutively admitted to 58 clinical centers during 8 months... 

Madhusoodanan S, Bogunovic OJ. Safety of benzodiazepines in the geriatric population. Expert Opin Drug Saf 2004 3(5) 485-93. 

Recently, in recognition of these limitations, several modifications in methodology have been introduced. For example, we now have more studies specifically aimed at the pediatric and geriatric populations, and certain studies require, for validity, the inclusion of minimal percentages of subjects from different ethnic or cultural groups. 

Sebaceous cysts are benign retention cysts of sebiun. They often appear in the geriatric population due to aging. Milia are small (0.5 mm), round, sebaceous cysts that tend to remain intracutaneous (Figure 23-24). They are common on the eyelids, are whitish in color, are found away from the lid margin, and cause little irritation.They are important only from a cosmetic standpoint. 

Roever C, Ferrante J, Gonzalez EC, Pal N, Roetzheim RG. Comparing the toxicity of digoxin and digitoxin in a geriatric population should an old drug be rediscovered South Med J 2000 93(2) 199-202. 

Heyd A, Haverstock D. Retrospective analysis of the safety profile of oral and intravenous ciprofloxacin in a geriatric population. Clin Ther 2000 22(10) 1239-50. 

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