The effect of community-acquired pneumonia on plasma esterases in older people

Abou-Hatab, Khaled; Ganeshalingam, Kandasamy; O'Mahony, M Sinead; Giurani, Fathi; Patel, Sarju; Woodhouse, K.W.

doi:10.1007/s002280000259

Cited by 10 publications

(3 citation statements)

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“…The effect of trauma on enzymes of drug metabolism may be related to the amount of injury, as relatively minor surgical interventions such as inguinal hernia repair are not associated with decrements in drug metabolism in man [46]. Other illnesses, which cause substantial acute inflammatory responses such as pneumonia, have also been found to be associated with reduced esterase activities in older patients [47]. Given the variability within the older population in terms of physical fitness/ frailty and their burden of illness/comorbidities, there is a need to individualize prescribing within this population.…”

Section: Frailty Esterases and Ageingmentioning

confidence: 99%

Drug metabolism and ageing

Kinirons

O'Mahony

2004

Brit J Clinical Pharma

198

101

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Important changes in drug metabolism occur with ageing. Age-associated reductions in function of some but not all cytochrome P450 enzymes (CYPs) have been described. Induction and inhibition of CYPs needs to be revisited in light of recent advances. The function and pharmacology of transporters have not yet been examined for an age-related effect. Finally, the concept of frailty is being underpinned by studies documenting a decline in drug metabolism and changes in disposition in frail older people compared with either healthy elderly or the young.

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Section: Frailty Esterases and Ageingmentioning

confidence: 99%

Drug metabolism and ageing

Kinirons

O'Mahony

2004

Brit J Clinical Pharma

198

101

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“…The susceptibility of other major CYP drug‐metabolizing enzymes appears to be intermediate between that of CYP3A4 and CYP2D6 [38–41]. Intercurrent stresses such as community‐acquired pneumonia, a fracture or hip replacement surgery have been shown to reduce the activity of aspirin esterase in older patients [42, 43].…”

Section: Age‐related Changes In Pharmacokineticsmentioning

confidence: 99%

“…The susceptibility of other major CYP drug-metabolizing enzymes appears to be intermediate between that of CYP3A4 and CYP2D6 [38][39][40][41]. Intercurrent stresses such as community-acquired pneumonia, a fracture or hip replacement surgery have been shown to reduce the activity of aspirin esterase in older patients [42,43]. For many of the alleged age-related changes in protein binding, fat content and drug metabolism, the evidence is modest and not consistent.…”

Section: Age-related Changes In Pharmacokineticsmentioning

confidence: 99%

Drug development and use in the elderly: search for the right dose and dosing regimen

Shah¹

2004

Brit J Clinical Pharma

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Across the globe over the last few decades, there has been a remarkable increase in the proportion of the population which is elderly, and this trend is set to continue. Data from 10 countries that accounted for about 55% of the world population of 6079 million in the year 2000 provide an overview of this significant shift in demography. Table 1 summarizes the projections for the next 25 years. Hitherto, increases in life expectancy have been most obvious in the affluent countries; however, improvements in public health and disease control are also leading to increases in life expectancy in the less affluent countries. As a result of relatively larger increases in life expectancy at birth, significant shifts in demography are also expected in countries that are at present economically less affluent. The number of elderly people in the world is therefore expected to continue to increase for some considerable time. Interestingly, the most dramatic increases in the proportion of the population who are elderly are anticipated in countries where total populations are projected to decrease (such as Japan, Germany and Italy).The 2001 population census of the UK revealed that since the census of 1951, the proportion of elderly population above 65 years and 85 years has increased from 16% and 0.4% respectively to 21% and 1.9%, respectively. These changes in demography will have significant effects on the economics generally as well as on the provisions for healthcare. Cardiovascular and neurological diseases and cancers are the most prevalent in the elderly. These three groups of diseases account for about 54% of the total burden of disease in Europe in terms of disability adjusted life years. Of the total gross Hospital and Community Health Services expenditure of £31.9 billion in the year 2001-2002 in the UK, 13% was expended on people aged 65-74 years, 16% on those aged 75-84 years and 10% for people aged 85 years or more. Furthermore, about 55% of the community prescriptions during 2001 in the UK were dispensed for the elderly. Cardiovascular and psychoactive drugs accounted for more than 40% of these prescriptions. In view of many age-related changes in the pharmacokinetics and pharmacodynamics of a drug, the safe and effective prescribing of medicines in the elderly will continue to present a major challenge.This review provides an overview of the issues relevant to development and clinical use of drugs in the elderly population, with particular reference to determining the right dosage and dose regimen and the regulatory requirements that facilitate this process. It also examines whether, as a result of advancing age per se, the dosing regimens in the elderly and the frail elderly might be different from those in the nonelderly.

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Role of the Laboratory in Detecting Other Poisoning, Including Pesticides, Ethylene Glycol, and Methanol

Dasgupta

2012

Resolving Erroneous Reports in Toxicology and Therapeutic Drug Monitoring

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The effect of community-acquired pneumonia on plasma esterases in older people

Cited by 10 publications

References 0 publications

Drug metabolism and ageing

Drug metabolism and ageing

Drug development and use in the elderly: search for the right dose and dosing regimen

Role of the Laboratory in Detecting Other Poisoning, Including Pesticides, Ethylene Glycol, and Methanol

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