Geriatric Pharmacotherapy in Dermatology and Adverce Drug Interactions
Özet
This chapter provides a comprehensive overview of pharmacotherapy in geriatric dermatology, explaining how age-related pharmacokinetic and pharmacodynamic changes increase the risk of drug interactions and adverse effects. The effects of aging-related decreases in renal and hepatic clearance, changes in body composition, and differences in protein binding levels on drug absorption, metabolism, and elimination are examined in detail. Pharmacokinetic interactions related to cytochrome P450 enzymes, P-glycoprotein transporters, and renal excretion are explained with dermatological examples. A comprehensive table presenting dose adjustments and contraindications for commonly used dermatological drugs is included. The chapter emphasizes the importance of individualized prescribing, regular monitoring of renal and hepatic functions, and avoiding polypharmacy. Clinical recommendations such as the “start low, go slow” approach and the use of digital tools to monitor drug–drug interactions are highlighted to improve safety in elderly dermatology patients.
Referanslar
America's Health Rankings analysis of CDC WONDER, Single-Race Population Estimates, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Xia, Fandi, Julia Cremer, and Daniel C. Butler. "DermatologyMedications in OlderAdults: Common Medications and Considerations." Current Geriatrics Reports 5 (2016): 259-265.
Chang, Anne Lynn S., ed. Advances in geriatric dermatology. Springer, 2015.
Kim, J.; Parish, A.L. Polypharmacy and Medication Management in Older Adults. Nurs. Clin. N. Am. 2017, 52, 457–468.
Turnheim, Klaus. "When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly." Experimental gerontology 38.8 (2003): 843-853.
Bteich M. An overview of albumin and alpha-1-acid glycoprotein main characteristics: highlighting the roles of amino acids in binding kinetics and molecular interactions. Heliyon. 2019 Nov 21;5(11):e02879.
Buxton ILO, Benet LZ. Chapter 2. pharmacokinetics: The dynamics of drug absorption, distribution, metabolism, and elimination 2011.
Konstandi M, Johnson EO. Age-related modifications in CYP-dependent drug metabolism: role of stress. Front Endocrinol (Lausanne). 2023 May 24;14:1143835
Mitchell, Sarah J., Alice E. Kane, and Sarah N. Hilmer. "Age‐related changes in the hepatic pharmacology and toxicology of paracetamol." Current gerontology and geriatrics research 2011.1
AlQashqri H. Renally Inappropriate Medications in the Old Population: Prevalence, Risk Factors, Adverse Outcomes, and Potential Interventions. Cureus. 2023 Nov 20;15(11):e49111.
Flammiger A, Maibach H. Drug dosage in the elderly: dermatological drugs. DrugsAging. 2006; 23(3):203–15.
Smith SA. Estimation of glomerular filtration rate from the serum creatinine concentration. PostgradMed J. 1988;64(749):204–8.
Bodey GP. Azole antifungal drugs. Clin Infect Dis 1992; 14: 5161-9
Palleria, Caterina, et al. "Pharmacokinetic drug-drug interaction and their implication in clinical management." Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 18.7 (2013): 601.
Chaithanya, K. J., B. S. Spurthi, and K. U. Janmita. "A Review: Pharmacokinetic Drug Interactions, A Primer For Clinical Pharmacist." IOSR Journal Of Pharmacy 10.8 (2020): 27-44.
Shapiro, Lori E., Sandra R. Knowles, and Neil H. Shear. "Drug interactions of clinical significance for the dermatologist: recognition and avoidance." American journal of clinical dermatology 4 (2003): 623-639.
Carrillo Norte JA. Pharmacokinetic process: Does the site of drug action? Excretion of drugs. Rev Enferm 2011;34:24 31.
Kido Y, Matsson P, Giacomini KM. Profiling of a prescription drug library for potential renal drug drug interactions mediated by the organic cation transporter 2. J Med Chem 2011;54:4548 58.
Uwai Y, Saito H, Inui K. Interaction between methotrexate and nonsteroidal anti-inflammatory drugs in organic anion transporter. Eur J Pharmacol. 2000 Dec 1;409(1):31-6.
Scaldaferri F, Pizzoferrato M, Ponziani FR, Gasbarrini G, GasbarriniA. Use and indications of cholestyramine and bile acid sequestrants. Intern Emerg Med 2011;8.
Kratzsch, Dorothea, and Regina Treudler. "Dermatologic therapy in geriatric patients." JDDG: Journal der Deutschen Dermatologischen Gesellschaft 12.8 (2014): 653-664.
22.Endo, Justin O., et al. "Geriatric dermatology: Part I. Geriatric pharmacology for the dermatologist." Journal of theAmerican Academy of Dermatology 68.4 (2013): 521-e1.
Zito PM, Patel P, Mazzoni T. Acitretin. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK519571/
Mohammadi O, Kassim TA. Azathioprine. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK542190/
Bounds CG, Patel P. Benzodiazepines. [Updated 2024 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK470159/
Tapia C, Nessel TA, Zito PM. Cyclosporine. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK482450/
Sidhu G, Akhondi H. Loratadine. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK542278/
Govindarajan A, Bistas KG, Ingold CJ, et al. Fluconazole. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK537158/
Kurn H, Wadhwa R. Itraconazole. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK557874/
Maxfield L, Preuss CV, Bermudez R. Terbinafine. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK545218/
