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Fiziološke posebnosti starostnikov in njihov vpliv na terapijo z zdravili
Vovk, Tomaž (Author)

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Abstract
Za starostnike je značilen upad fizioloških funkcij, pogostejša obolevnost interapija z veoe zdravili hkrati. Te lastnosti lahko bistveno vplivajo na farmakoterapijo starostnikov. Fiziološke spremembe se pri starostnikih kažejo v spremenjeni farmakokinetiki in farmakodinamiki zdravil. Med farmakokinetičnimi procesi je pri starostnikih največje spremembe opaziti na nivoju metabolizma v jetrih in izločanja preko ledvic. To lahko vodi do zmanjšanja metabolizma predvsem pri učinkovinah, katerih metabolizem je omejen s pretokom krvi skozi jetra. Zmanjšano izločanje preko ledvic pa je lahko klinično pomembno predvsem za učinkovine, ki se izločajo iz telesa le preko ledvic in imajo hkrati tudi ozko terapevtsko širino. Farmakodinamične spremembe se pri starostnikih lahko pokažejo na nivoju receptorjev, prevajanja signalov ali homeostatskih mehanizmov. S stališča farmakoterapije so pri starostnikih najpomembnejše farmakodinamične spremembe opazne na centralnem živčnem, kardiovaskularnem in respiratornem sistemu. Neglede na trenutno poznavanje fizioloških sprememb pri starostnikih,bi boljše razumevanje sprememb lahko pripomoglo k večji učinkovitosti in varnosti farmakoterapije pri starostnikih.

Language:Slovenian
Keywords:starostniki, fiziološke spremembe, zdravila, farmakokinetika, farmakodinamika
Work type:Not categorized (r6)
Tipology:1.02 - Review Article
Organization:FFA - Faculty of Pharmacy
Year:2010
Publisher:Slovensko farmacevtsko društvo
Number of pages:str. 221-226
Numbering:Let. 61, št. 4
UDC:615.015
ISSN on article:0014-8229
COBISS.SI-ID:2870385 Link is opened in a new window
Views:1394
Downloads:145
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Record is a part of a journal

Title:Farmacevtski vestnik
Shortened title:Farm. vestn.
Publisher:Slovensko farmacevtsko društvo
ISSN:0014-8229
COBISS.SI-ID:3105794 This link opens in a new window

Secondary language

Language:English
Title:Impact of physiological changes on pharmacotherapy in the elderly
Abstract:
Elderly are characterized by impairment in the physiological functions, comorbidity and polypharmacy. These characteristics influence their pharmacotherapy. Age-related physiological changes influence drug pharmacokinetics and pharmacodynamics. Important pharmacokinetic changes are observed in drug metabolism in the liver and elimination via kidney. Drugs with blood flow limited metabolism are most prone to decreased metabolism. Renal elimination is decreased and clinically important for drugs which are predominantly eliminated from the human body via kidney and have low therapeutic index. Age-related changes in pharmacodynamics may occur at the receptor, signal transduction or homeostatic mechanisms levels. The most important physiological changes which concern pharmacotherapy are observed in central neural, cardiovascular and respiratory system. Regardless of the present knowledge of physiological changes in the elderly, a better understanding of changes could improve the efficacy and safety aspects of pharmacotherapy in elderly.


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