Pharmacodynamic Principles of Drug Therapy in the Aged*

Bender, A. Douglas

doi:10.1111/j.1532-5415.1974.tb05397.x

Cited by 44 publications

(10 citation statements)

References 55 publications

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“…In children, as in elderly subjects, the serum concentrations of these products are higher than those observed in adults. [47][48][49][50] Investigations on penicillin carried out with shortacting penicillins (those eliminated within a few hours) prescribed in a single dose, whatever the route of administration, corroborated our results.…”

Section: Discussionsupporting

confidence: 80%

Kinetic study of serum penicillin concentrations after single doses of benzathine and benethamine penicillins in young and old people.

Collart¹,

Poitevin²,

Milovanović³

et al. 1980

Sexually Transmitted Infections

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SUMMARY In a comparative kinetic study of the serum concentrations of two penicillin complexes-medium-long-acting (benethamine penicillin) and long-acting (benzathine bipenicillin)-after a single injection in young adults and elderly people, the following results were confirmed statistically: (a) age was a major factor in the variations in serum penicillin concentrations and in their persistence in the serum; (b) the penicillin was absorbed faster in young than in elderly subjects even when a long-acting complex was used; (c) serum concentrations below the level regarded as lethal for treponemes appeared much earlier and more frequently in young than in old people; and (d) the bioequivalence between penicillin preparations could not be estimated solely from the number of units of the agent used but from the bioavailability of the chosen formulation.Thus a uniform and standard penicillin dosage allowing no safety margin may help in the superficial healing of a syphilitic chancre or the resolution of a roseola but it will certainly be insufficient to kill Treponema pallidum. It seems essential therefore to provide an antibiotic cover at high dosage over a long period of time.

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Section: Discussionsupporting

confidence: 80%

Kinetic study of serum penicillin concentrations after single doses of benzathine and benethamine penicillins in young and old people.

Collart¹,

Poitevin²,

Milovanović³

et al. 1980

Sexually Transmitted Infections

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show abstract

“…This is unlikely to occur, since oral daily dosages generally do not correlate with plasma concentrations, which are the result of individual pharmacokinetic variations. [26][27][28][29][30][31][32] The problem is accentuated by the fact that plasma levels do not necessarily correlate with brain tissue levels." Therefore, the quantity of anticholinergic taken would not necessarily represent the actual receptor site concentration.…”

Section: Discussionmentioning

confidence: 99%

Use of Anticholinergics in the Nursing Home: An Empirical Study and Review

Seifert¹,

Jamieson²,

Gardner³

1983

Drug Intelligence & Clinical Pharmacy

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The Medicare Utilization Review Committee conducted a survey to determine the use of drugs with anticholinergic effects in confused elderly nursing home patients. Twenty-nine patients (34.5 percent) were receiving anticholinergic drugs, predominantly from the antidepressant and antipsychotic class. Thioridazine (Mellaril) was the most frequently used antipsychotic. No patients received higher than the equivalent recommended daily dose of atropine when calculated in terms of relative anticholinergic potency. No statistically significant correlation could be found between the presence of confusion and the amount of anticholinergics administered. Confusion and cognitive deterioration frequently are encountered when caring for aged patients. Clinical experience and recent studies suggest that anticholinergics may increase the risk of or exacerbate existing confusion, and this possible effect of anticholinergic activity should be considered when prescribing for elderly patients.

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Section: Discussionmentioning

confidence: 99%

“…The potential for increased drug toxicity in the elderly population is well recognized (12,13). Although it is generally attributed to defective metabolic handling (13), patient and physician malcompliance contribute to the potential development of adverse effects. The use of gold therapy in the elderly RA patient has received little attention in the rheumatology literature, and the few reports to date state that injectable gold is less efficacious (6) and more toxic (7) in the elderly RA patient than in the young group.…”

Section: Discussionmentioning

confidence: 99%

Gold Therapy in The Elderly Rheumatoid Arthritis Patient

Kean

Bellamy

Brooks

1983

Arthritis & Rheumatism

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Forty elderly (≥60 years old) and 101 young (<60 years old) rheumatoid arthritis patients receiving injectable gold therapy were followed prospectively between April 1971 and April 1982. The mean total gold compound received was 1,392 mg in the young group and 1,861 in the elderly group. Besides age, the only significant difference between the two groups was the increased gold compound received by the elderly. To determine efficacy and toxicity within and between certain age groups, the 141 patients were divided into 4 arbitrary age groups: group A (<30 years), group B (30—44 years), group C (45–59 years), and group D (≥60 years). The elderly responded to the gold therapy as well as the young patients did, at any time frame examined after 3 months of therapy. There was no difference in clinical benefit among groups A, B, C, and D. Nine patients in the elderly group and 15 in the young group had therapy discontinued because of no response. This difference was not significant among the groups A, B, C, and D. There was no difference in outcome of individual toxicity between the elderly and the young groups, and no difference in frequency of toxicity between the age groups A, B, C, and D. Serious hematologic toxicity occurred only in patients over 47 years of age, and nephrotic syndrome occurred only in patients over 52. In this study, gold therapy was found to be as clinically beneficial in the elderly as in the young patients, and the toxicity and drug failure rates were not significantly different.

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Pharmacodynamic Principles of Drug Therapy in the Aged*

Cited by 44 publications

References 55 publications

Kinetic study of serum penicillin concentrations after single doses of benzathine and benethamine penicillins in young and old people.

Kinetic study of serum penicillin concentrations after single doses of benzathine and benethamine penicillins in young and old people.

Use of Anticholinergics in the Nursing Home: An Empirical Study and Review

Gold Therapy in The Elderly Rheumatoid Arthritis Patient

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