Abstract:
:Although the increased need for studies assessing the influence of age on the pharmacokinetics and pharmacodynamics of all drugs has been emphasized, relatively little is known about NSAIDs in the elderly. The pharmacokinetics of some NSAIDs have been examined in elderly subjects; unfortunately, recent data indicate that much of the earlier information may be incomplete or even misleading. Many studies report the disposition of only total NSAIDs. Since all of the NSAIDs are highly protein bound, it is the unbound, pharmacologically active, fraction that is most important. Few studies have quantified the pharmacokinetics of unbound NSAID in any age group, much less in elderly patients. Also, it is now apparent that studies of the propionic acid derivatives and other drugs with chiral centers must assess the disposition of the active S-enantiomer. Finally, studies of NSAIDs that form acylglucuronides are confounded by the reversion of these metabolites to active drug. Reduced renal elimination of these metabolites may be greater in elderly persons. Studies that account for these features of NSAIDs will provide necessary data for safe and effective use of NSAIDs in the elderly.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
Murray MD,Brater DCsubject
Has Abstractpub_date
1990-05-01 00:00:00pages
365-97issue
2eissn
0749-0690issn
1879-8853journal_volume
6pub_type
杂志文章,评审abstract::The treatment of nonpain symptoms is integral to good palliative care of the terminally ill elder. This article reviews the management of common physical symptoms observed during the dying process, including nausea and vomiting, dyspnea, cough, constipation, diarrhea, bowel obstruction, and xerostomia. Alleviation of ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00
abstract::Pain is a common problem encountered among elderly people in subacute and long-term care facilities. Pain often is underestimated and undertreated in these settings. Most pain problems can be improved by careful assessment and careful use of analgesic drugs and nondrug strategies. Subacute care and other long-term car...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(05)70048-3
更新日期:2000-11-01 00:00:00
abstract::This article provides a brief overview of the challenges and opportunities of new technologies in the area of geriatric pain management. It also reviews emerging evidence to demonstrate the role technology may play in improving and advancing assessment and management of pain in older adults. ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2016.06.011
更新日期:2016-11-01 00:00:00
abstract::The geriatric population has become a major component in the practice of medical speech-language pathology. This article discusses normal and abnormal functions of speech, voicing, language, cognition, and swallowing. Particular attention is given to disorders affecting the geriatric population. Evaluation, treatment,...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2005.12.008
更新日期:2006-05-01 00:00:00
abstract::In developing and validating the concept of frailty as a geriatric syndrome, it has been necessary to distinguish the clinical expression of frailty from normal age-related changes and other age-related disease pathologies. A framework for excluding potentially confounding disease and a working clinical tool to diagno...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:10.1016/j.cger.2010.08.006
更新日期:2011-02-01 00:00:00
abstract::This article summarizes the common, superficial, cutaneous, fungal infections that are found in older adults. The epidemiology, classic appearance, and current treatments of these fungal infections are discussed. These common skin pathogens occur in many older adults. ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:10.1016/j.cger.2013.01.001
更新日期:2013-05-01 00:00:00
abstract::This article reviews the clinical manifestations, diagnostic criteria, and treatment strategies for the acute leukemias, the myelodysplastic syndrome, Hodgkin's disease, and the non-Hodgkin's lymphomas in the elderly. These are relatively common diseases in the elderly, and age is traditionally thought to be a bad pro...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1985-11-01 00:00:00
abstract::There is no single definition of polypharmacy. Use of 5 or more medications commonly is used. An alternative, quantitative definition, such as use of more medications than clinically indicated or use of unnecessary or harmful prescribing, has been proposed. Protocols or algorithms to improve polypharmacy and prescribi...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2017.01.007
更新日期:2017-05-01 00:00:00
abstract::To summarize, there has been shamefully little empirical research directly examining the prevalence and correlates of pain among cognitively impaired older people. Even less is known about techniques for assessing and managing pain in this group. Existing evidence suggests that cognitively impaired older persons may v...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-08-01 00:00:00
abstract::Intraperitoneal infections or inflammatory disease in elderly patients are a diagnostic challenge that will be encountered with increasing frequency in the aging population of the United States. Diagnostic clues are not overt and frequently appear late in the course of the disease. Confusion and subtle changes in clin...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-11-01 00:00:00
abstract::The oral cavity is responsible for two essential functions: the production of speech and the initiation of alimentation. All of the specialized oral tissues and sensory systems that allow for the execution of these functions are susceptible to age-, disease-, and treatment-related changes, and alterations in any one o...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::Patients often present for evaluation of a suspicious cancer symptom after a delay. They appear to tolerate cancer treatment as well as younger patients, and, in studies comparing them on psychosocial parameters of adaptation, they appear to adjust better than younger patients. Attention to pre-existing social problem...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1987-08-01 00:00:00
abstract::An understanding of the causes, nature, and course of intellectual impairment in Parkinson's disease (PD) is essential for the correct development of therapy. This article reviews the causes of the dementia of PD, its primary clinical and pathological features, and its course. ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1988-11-01 00:00:00
abstract::Although exercise capacity declines with age, the decline appears to be slight when measured in healthy, physically active subjects. There is growing evidence that exercise has a positive influence on increasing healthy function and decreasing the impact of diseases common in the elderly. While the dose-response relat...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1988-02-01 00:00:00
abstract::Improvements in delivery systems for enteral feeding, in formulas, and in the understanding of complications have made the technology for enteral feeding easy to apply. Adequate nutrients can be delivered, and individual tolerance for feeding is acceptable. The remaining question is when to apply the technology. Formu...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(02)00035-6
更新日期:2002-11-01 00:00:00
abstract::There are three major obstacles to a recommendation for screening the elderly for NIDDM. The first is the conflicting evidence as to whether early detection and treatment reduce complications. The second is that treatment of hyperglycemia with attainment of euglycemia is difficult to achieve in the elderly. Nondrug th...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-11-01 00:00:00
abstract::Despite the considerable challenges to providing high-quality rehabilitation in a long-term care facility, growing demographic and fiscal pressures are likely to push the nursing home into the forefront of rehabilitation for the frail elderly. Model programs have been implemented in recent years that present alternati...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract::Suicide in the elderly is a growing problem. The elderly population is increasing, and elderly patients have multiple issues that place them at higher risk of suicidality. These issues include physical illnesses, mental illness, loss of functional status, isolation, and family, financial, and social factors. Access to...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2018.08.012
更新日期:2019-02-01 00:00:00
abstract::The number of patients with atrial fibrillation (AF) who are of advanced age or have multiple comorbidities is expected to increase substantially. Older patients with AF generally gain a net benefit from anticoagulation. Guidelines typically recommend anticoagulation. There are multiple challenges in the safe use of a...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2016.01.003
更新日期:2016-05-01 00:00:00
abstract::The aging kidney suffers reduction both in mass and in glomerular filtration rate. These changes may be totally or partially due to atherosclerosis and hypertension, which reduce renal blood flow. Superimposed on these processes, and perhaps responsible for primary loss of renal mass irrespective of renal vascular dis...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1985-02-01 00:00:00
abstract::As knowledge of molecular and cellular mechanisms of development and aging is elucidated, the need to understand the relationships among tissues, organ systems, health habits, nutrition, physical activity, and environmental factors on successful aging becomes more explicit. Progress in our understanding of how the imm...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1997-11-01 00:00:00
abstract::This paper presents process and outcome data for a geriatric assessment unit in a rehabilitation hospital whose focus is on short-term rehabilitation. While the results presented here are positive, they are descriptive and do not prove a cause and effect relationship between the geriatric assessment and rehabilitation...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:
更新日期:1987-02-01 00:00:00
abstract::Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia following Alzheimer disease. It stems from the formation of Lewy bodies, which contain aggregates of the misfolded protein, α-synuclein. These deposit in areas of the nervous system and brain, leading to neuronal cell death and causin...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2018.06.007
更新日期:2018-11-01 00:00:00
abstract::In conclusion, the majority, or at least a large proportion, of accidental injuries in the elderly are preventable with careful medical and environmental evaluation and intervention. A vigorous diagnostic, therapeutic, and preventive approach is appropriate in all older patients who fall in addition to those at a high...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-11-01 00:00:00
abstract::Urinary incontinence is a prevalent condition in elderly women with significant associated morbidity. Incontinence can by grouped into several types: stress incontinence, urgency incontinence, overflow incontinence, functional incontinence, and mixed urinary incontinence. Careful evaluation, including history and phys...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2015.07.003
更新日期:2015-11-01 00:00:00
abstract::Behavioral signs and symptoms in dementia are common, morbid, classifiable, and treatable. The current state-of-the-art approach is to evaluate carefully for social or environmental causes, intercurrent medical conditions, or other triggers of the behavior and attempt to deal with those directly. When these conservati...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(05)70073-2
更新日期:2001-05-01 00:00:00
abstract::The rapid growth of the geriatric sector of the population has, in part, led to the explosion of the home care industry and the rebirth of the house call. Understanding the population being served is always the first step in providing excellent care. Older people who are frail and homebound have physical, social, and ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(05)70010-0
更新日期:2000-02-01 00:00:00
abstract::American health-care practitioners are faced with a rapidly growing, geriatric, Hispanic-American population. This group shares certain cultural links but is largely heterogeneous and comprised of many subgroups, the largest of which are Mexican Americans, Puerto Ricans, and Cuban Americans. Health-care practitioners ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract::Balance disorders are common in the elderly and can lead to falls, with resultant severe morbidity and even mortality. Progressive loss of vestibular function begins in middle age and is affected by multiple disease processes. Polypharmacy impacts many disease processes in the elderly, with balance function being one ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2018.01.002
更新日期:2018-05-01 00:00:00
abstract::The elderly have few bleeding disorders related exclusively to the aging process. However, abnormalities of coagulation are seen frequently in this group as complications of other illnesses. Thus a good understanding of basic coagulation physiology and testing will provide the necessary tools for therapeutic guidance....
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00