Response To Pharmacokinetics

Polypharmacy is a phenomena referred to as the intake of multiple medication by a patient, due to multiple medical conditions by a patient. It also is used for the pill burden that a patient has under such circumstances, majorly a problem for elderly people. Sometimes the combination they take may result in a side effect, because of a drug to drug reaction rather than curing. Moreover, due to similar names of the medicines such mishaps could result too. It especially turns into a menace when people self medicate, not knowing about the lethal combinations that may come forward.

The absorption of drugs differ in the elderly than they do in adults. Absorption primary occurs in the gastrointestinal system. The pH in the gastro intestinal system is higher because of the reduction in acid production in the stomach. Emptying is also decreased; this does not allow the drug to move on further into the system to be absorbed. Blood flow to the gastrointestinal system is reduced by 40-50% because of the decrease in cardiac output and decreased perfusion. The reduction of blood flow causes the villi in the stomach lining to become blunt and flattened. The reduction in blood flow and surface area results in the decreased absorption of drugs. (Lilley, Collins, and Snyder

Human health and theIR quality of life have been improving in the past 100 due to changes in medicine and in public health (Mattes et al., 2013). Patients are placed on multiple medications at the same time and it important to understand their safety, efficacy, drug interaction, and toxicity (Mattes et al., 2013). As Mr. Cynthia Nurse practitioner, my job is to understand what affect her prescribing medication is having on her body. I have place Mrs. Cynthia on Lisinopril for her hypertension and metformin for her type II diabetes.

Senior citizens are the people who are most likely to take multiple medications due to the occurring chronic conditions as the aging process continues. Given the several medicines they take, they are ironically the age group that is very much sensitive to medication side effects, both therapeutic and negative.

Older adults commonly take NSAIDS chronically. There are a lot of adverse effects associated with chronic NSAID use including the risk of peptic ulcer disease, acute renal failure, and stroke/myocardial infarction, as well as exacerbate a number of chronic diseases including heart failure and hypertension, and can interact with a number of drugs (eg, warfarin, corticosteroids) ultimately increasing hospitalizations in the elderly population.

Drug therapy always carries risks, but in older populations, that risk is at times amplified due to normal physiological variations. When considering drug therapy for an older

Dosing. Physiologic changes in the elderly make medication dosing tricky. Adjustments have to be made owing to age-related reduction in liver and kidney functions, as well as the presence of coexisting comorbidities and use of other medications for these pre-existing conditions. The BEERS list, a compilation of potentially harmful medications to the elderly, was drafted in an attempt to curb the rising incidence of avoidable adverse medication effects in this population.

The main concern about having the elderly on so many medications at once is the chance of adverse drug reactions from potential drug interactions. They can be on both prescribed medications and over the counter medications, vitamins, or supplements. The most common over the counter medications that often lead to serious adverse drug reactions include acetaminophen, ibuprofen, and aspirin (Woodruff, 2010). Another reason that the elderly are more susceptible to adverse drug reactions is the fat and water composition changes, they have increased fat storage and decreased total body water, this allows for higher concentration of water soluble drugs and longer half-lives of fat soluble drugs (Woodruff, 2010). Changes in the liver and

Age plays an important factor when considering prescribing drugs as the very young and the elderly will have difficulty with the metabolism and excretion of drugs. Even the healthiest of the ageing population will have a degree of renal impairment which delays excretion through the kidneys, increasing the duration of action. However when dealing with an acute illness, which are the patients I encounter, a further and rapid reduction in clearance will exacerbate this process. Liver function may also be impaired during acute illness resulting in delayed drug metabolism (Beckworth & Franklin, 2007). Therefore, before any prescribing can take place a diagnosis must be accurately made and underpinned by an understanding of basic pathophysiology eg, a recent review of bloods to assess renal

“polypharmacy as the use of five or more prescription medications—is common among seniors and can lead to reduced compliance with medication regimens and problems with drug–drug interactions” (2012, p.428). Elderly patients are mostly at risk to polypharmacy issues due to aging effects on how the body tolerates medications, and also, as a result of taking more medications than younger patients. Reason et al., continues to demonstrate that the use of prescription increase with age and in association with multiple morbidities in the elderly patients. Medications such as over the counter drugs, herbal preps, and home remedies are widely used by older adults. These medications have a higher risk of causing adverse drug reaction especially with

Pharmacokinetics (PK): Well absorbed in the gastrointestinal tract, metabolised in the liver and excreted in the urine. 1-2,4 The average PK parameters of DVS with once-daily dosing are1,4:

The most common genes that affect drug metabolism are the cytochrome P450 (CYP) genes, which control the reaction of more than 70 percent of prescribed drugs. If you have variants of CYP genes, you may not get the predicted therapeutic benefit of the drug, or you may experience serious side effects. If the gene variant results in a slower rate of drug metabolism, the drug may build up in your body and cause a toxic reaction. If your genetic make-up causes a faster rate of drug metabolism, the medicine may be inactivated before you get the therapeutic benefit. If you have a genetic variant that is associated with the way a medicine may perform, your doctor can devise a drug treatment plan that includes medicines and doses that are safe and effective for

The pharmacokinetics and pharmacodynamics of many commonly used drugs vary significantly across all age groups. Adverse Drug Reactions are one of the major concerns in the elderly. Adverse drug reactions, especially those that may be preventable, are among the most serious concerns about medication use in elderly in clinical setting. The incidence of adverse drug reactions in patients more than 60 years old compared with younger patients (age less than 30 years) increased by two or threefold. The ageing process is associated with physiological and pathological changes. It then makes individuals at a higher risk of multiple morbidity and treatment-related complications. Predisposing factors to adverse drug reactions which have been noted including

Polypharmacy is the use of many different drugs concurrently in treating patient who often has several health problems. The growing geriatric population consumes the largest proportion of all medication than of other population groups. In Canada alone, one in three older adults takes more than 8 different drugs each day, and some take as many as 15 or more (Lilley, 2011). Polypharmacy can lead to what is known as the “prescribing cascade”, in which older adults develop adverse effects from one or more of the medications taken and the health care provider then prescribe another drug. The risk for drug interactions, adverse effects, and hospitalization is far greater in this situation. Acknowledging polypharmacy in a patients and

Polypharmacy is primarily defined as the concurrent use of five or more medications by a patient, and is widely seen in older adults. The frequency of polypharmacy in elderly patients likely reflects the necessity to treat acute ailments, chronic disease states and co-morbid conditions. While the use of combination drug therapy is often necessary, the combination of aging, inappropriate prescribing and polypharmacy can result in significant adverse events, drug-drug interactions, increased fall risk and hospitalizations. Studies indicate that approximately 50% of elderly patients are prescribed medications with no clinical benefit or indication.[1]Geriatric patents are more susceptible to adverse drug events due to physiological changes, therefore it is imperative to understand..