Good for the elderly
Because of metabolic changes and slower medication clearance associated with age, older adults are at increased risk for adverse drug reactions (ADEs). This risk is compounded by the rising number of pharmaceuticals being taken. Polypharmacy raises the likelihood of drug-drug interactions as well as the prescription of drugs that are possibly unsuitable for the patient.
Digoxin metabolism and clearance can be affected by functional decline of the liver and, in particular, the kidneys, which is more common in the aged population. 15,18 It should be noted that digoxin is very hydrophilic, and that the dose-effect relationship is reliant on lean body mass; therefore, the dosage should be calculated using the optimal body weight.
The vast majority of poisoning instances involving the elderly are unintended and accidental in their occurrences. Most of the time, they can be explained by the following scenarios: There are several causes of dementia and confusion, including: 1) incorrect use of the product, 2) poor storage of the agent, and 3) mistaken identification.
The immune system of older people is less developed, making them more susceptible to infectious diseases than younger ones. Their bodies’ capacity to fight infectious disease is further diminished if they have disorders such as heart disease, chronic obstructive pulmonary disease, diabetes, or renal disease, which all compromise their immune system.
Age-Related Decreased Blood-Pressure Maintaining Ability: Because older persons are less able to adjust for some of the effects of medications, there is still another reason why they are more prone to the harmful effects of medications and more sensitive to the intended effects of medications.
Increased Sensitivity to a Wide Range of Drugs: The problems of decreased body size, altered body composition (more fat, less water), and decreased liver and kidney function cause many drugs to accumulate in the bodies of older people at dangerously higher levels and for longer periods of time than in younger people.Many drugs accumulate at dangerously higher levels and for longer periods of time in older people than in younger people.
The more frail and elderly patients with coexisting diseases, who are frequently receiving other treatments, are at greater risk of digoxin toxicity due to inappropriate dosing, noncompliance, or increased sensitivity to digoxin as a result of pharmacokinetic or pharmacodynamic interactions with other medications.
First-pass metabolism (metabolism that happens before a medication enters systemic circulation, which is often hepatic) is similarly impacted by aging, with levels dropping by around 1 percent every year beyond the age of 40. As a result, older persons may have greater circulatory medication concentrations after taking a given oral dosage.
The incidence of adverse drug reactions (ADRs) rises with age, with individuals 65 years and older being twice as likely as younger patients to be admitted to the hospital as they are for ADR-related concerns.
Because of concurrent disease, intake of other prescription and over-the-counter medications, dosage miscalculation due to forgetfulness, and changed drug kinetics, older persons are more likely than younger people to experience adverse effects when taking any medicine, including antidepressants.
Chronic illnesses such as dementias, heart disease, type 2 diabetes, arthritis, and cancer are all increased in risk as people get older. These are the most significant contributors to disease, disability, mortality, and health-care expenses in the United States.
When people get older, they are more likely to develop chronic digoxin toxicity as a result of reduced digoxin clearance, which can be caused by either deteriorating renal function or drug-drug interactions. Chronic digoxin poisoning is characterized by symptoms such as nausea, malaise, and weakness.
People over the age of 65 are at greater risk of digoxin poisoning. In individuals with heart failure caused by systolic dysfunction, low doses of digoxin appear to be efficient in reducing their risk of digitalis toxicity, which may be beneficial.
Digoxin toxicity is actually increased in instances of hypokalemia, or low potassium, since digoxin generally attaches to the ATPase pump at the same location as potassium, which makes it more toxic. The presence of low potassium levels allows digoxin to more readily attach itself to the ATPase pump, resulting in greater inhibition of the pump’s function
Because ageing is related with a decline in first-pass metabolism, it may be possible to boost the bioavailability of a few medications. As we get older, our body fat grows, but our total body water and lean body mass both decrease.
It is possible to get toxic from drugs if you take too much medicine at the same time. This is known as overdosing on a medication. This can occur if the dosage consumed is greater than the authorized dose, whether intentionally or accidently, and the dose taken exceeds the specified dose. Drug toxicity, which can manifest itself as an adverse drug response in some drugs, is possible (ADR).
Increased body fat, decreased body water, decreased muscle mass, as well as alterations in renal and hepatic function, as well as changes in the Central Nervous System, are all manifestations of this condition. Adverse drug responses (ADRs) can occur in elderly adults as a result of these changes.
Patients above the age of 65 are at greater risk for adverse drug events (ADEs) and medication interactions. Every year, ADEs are responsible for almost 700,000 visits to the emergency room and 100,000 hospitalizations.
Intravenous administration avoids the need to pass through absorption obstacles. It has the potential to be the most dangerous route of administration since a high concentration of medication is supplied to organs at the same pace as the rate of injection, which may result in toxic consequences in some cases.