Clinical Pharmacology in the Elderly

Reference Ranges and Biological Variations After Repeated Measurements

Paperback Engels 1995 9783540594956
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Samenvatting

The appropriate and rational use of drugs by the elderly is a matter of growing medical and social concern. Persons aged 65 years and older constitute about 12%-15% of the population in the Western world, and the total number of the elderly will increase significantly in the coming years. This population accounts for 30% of all the prescription drugs used. Aging, specifically the transition from middle to old age, is a complex process. From the perspective of clinical pharmacology, these pathophysiological changes may reasonably be expected to alter responsiveness to drugs. The age-related differences in response to drugs can arise from alterations in pharmacokinetics or pharmacodynamics. This makes it mandatory that clinical pharma­ cological studies be carried out in the elderly during extended phase I studies. The older the population likely to use the drug, the more important it is to include the very old. It is also important not to exclude .... :''lecessarily patients with concomitant illnesses; it is only by observing, such patients that drug-disease interactions can be detected. Reports from surveillance systems have greatly increased our awareness of problems associated with drug therapy in old age.

Specificaties

ISBN13:9783540594956
Taal:Engels
Bindwijze:paperback
Aantal pagina's:182
Uitgever:Springer Berlin Heidelberg
Druk:0

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Inhoudsopgave

1 Introduction.- 2 Theories of Aging.- 3 Changes in Body Functions, Pharmacokinetics, and Receptor Sensitivity with Age.- 3.1 Changes in Central Nervous System.- 3.1.1 Brain Structure and Function.- 3.1.2 Electroencephalogram.- 3.1.2 Cognitive Performance and Behavior.- 3.2 Cardiovascular and Pulmonary Changes.- 3.2.1 Heart.- 3.2.2 Blood Pressure.- 3.2.3 Arrhythmias.- 3.2.4 Lung.- 3.3 Changes in Clinical Chemistry and Hematology.- 3.3.1 Clinical Chemistry.- 3.3.2 Hematology.- 3.3.3 Repeated Measurements of Clinical Chemistry and Hematological Variables.- 3.3.4 Biological Rhythms.- 3.4 Changes in Pharmacokinetics.- 3.4.1 Absorption.- 3.4.2 Distribution.- 3.4.3 Protein Binding.- 3.4.4 Metabolism.- 3.4.5 Excretion.- 3.5 Changes in Receptor Sensitivity.- 4 Practical Aspects in Performing Clinical Trials in Elderly Subjects.- 4.1 Recruitment of Subjects.- 4.2 Performance of the Study.- 4.3 Safety Aspects.- 4.4 Sample Size.- 4.5 Compliance of Subjects with Medication and Study Regulations.- 5 Experimental Findings in Elderly Subjects.- 5.1 Method.- 5.1.1 Inclusion Criteria.- 5.1.2 Exclusion Criteria.- 5.1.3 Technical Methods.- 5.1.4 Data Management and Statistics.- 5.2 Experimental Data.- 5.2.1 Blood Pressure and Pulse Rate.- 5.2.2 Ambulatory Blood Pressure Monitoring.- 5.2.3 ECG Times.- 5.2.4 Ambulatory ECG Monitoring.- 5.2.5 Spirometry (FEV1).- 5.2.6 Clinical Chemistry.- 5.2.7 Hematology.- 5.2.8 Adverse Events.- 5.3 Consequences from Experimental Data in Healthy Subjects.- 6 Statistical Details.- 6.1 Blood Pressure.- 6.1.1 Baseline Values.- 6.1.2 Changes During Study Day.- 6.1.3 Changes After Repeated Measurements.- 6.2 Ambulatory Blood Pressure Monitoring.- 6.2.1 Baseline Values.- 6.2.2 Changes After 2 Weeks.- 6.3 ECG Times.- 6.3.1 Baseline Values.- 6.3.2 Changes During Study Day.- 6.3.3 Changes After Repeated Measurements.- 6.4 Ambulatory ECG Monitoring.- 6.4.1 Baseline Values.- 6.4.2 Changes After 2—3 Weeks.- 6.5 Spirometry (FEV1).- 6.5.1 Baseline Values.- 6.5.2 Changes During Study Day and After 1 Week.- 6.6 Clinical Chemistry.- 6.6.1 Baseline Values.- 6.6.2 Changes After Repeated Measurements.- 6.7 Hematology.- 6.7.1 Baseline Values.- 6.7.2 Changes After Repeated Measurements.- References.

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