Kuopio Centre of Geriatric Nutrition and Drug Research

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Kuopio Centre of Geriatric Nutrition and Drug
Research

• Sirpa Hartikainen
• Reseach Manager in GEMS-study
• University of Kuopio
• Departement of Public Health and General
  Practice
• Division of Geriatrics
• Senior Consultant in Geriatrics
• City of Kuopio

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KUOPIO CENTRE FOR GERIATRIC NUTRITION AND DRUG
RESEARCH
Pharmaceutical faculty
Food and Health Research Centre Dept of Clinical
Nutrition
KUOPIO CENTRE FOR GERIATRIC NUTRITION AND DRUG
RESEARCH
Companies City Research partners
Dept of Public Health and General Practice
DEVELOPS TESTS STUDIES
PRODUCES




HELATH TECHNOLOGY
FOOD
HEALTH CARE AND SERVICES
DRUGS
WELL-BEING OF ELDERLY
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Geriatric Drug Research

• PhD, MD Sirpa Hartikainen
• Department of Public Health and General Practice,
  Division of Geriatrics
• Professor Tomi Järvinen
• Department of Pharmaceutical Chemistry
• Professor Hannes Enlund
• Department of Social Pharmacy
• Professor Hannu Kokki
• Department of Pharmacology and Toxicology

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Challenges in medication

• Persons aged over 65 years - 15 of population
  in Finland
• use more than half of all medicines
• use 40 of all drug costs
• Persons aged over 75 years - 7 of population
  in Finland
• use one third of all medicines
• Among the elderly it is rare not to use any drug

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Changes in pharmacokinetics in aged persons
Absorption
Distribution
Gastro- interstinal
Plasma
Drug
Metabolism
Excretion
Action
Store in the body
Elimination
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Are age related changes in pharmacokinetics and
pharmacodynamics clinically relevant?
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Changes in body composition

• Same dose of medicine
• therapeutic effect in middle-aged persons
• gt too high plama concentration for aged
  persons
• gt side effects, even dangerous side-effects
• Elderly persons get a therapeutic effect with
  lower plasma concentrations than younger adults

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Changes in excretion

• In elderly persons kidneys capacity to excrete
  medicines is about half compared to young adults
• Fat-soluble drugs stay for a longer time in the
  aged body
• A half-life diazepam can chance from one day
  (young adult) to several days or even to over ine
  week

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Specific dosage forms and administration routes
are needed

• The elderly persons, especially most frail
  persons have difficulties in swallowing or
  chewing solid dosage forms of medicines
• fast-dissolving drug delivery
• systems

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Problems in drug reaseach

• Drugs that are now in use, are not studied in
  persons aged over 75 years!
• New drugs do not need to studied properly in
  persons aged over 75 years!

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Geriatric Drug ResearchObjectives

• 1. Geriatric epidemiological and clinical studies
  (GEMS)
• 2. To identify specific problems in drug
  treatment
• 2. To study pharmacokinetics in the elderly
  persons (GEMS)
• 3. To create new drug development ideas
• 4. Drug development projects to create new
  products for elderly, in collaboration with the
  local pharmaceutical companies.

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Epidemiological studies GEMS- An example of our
studies

• Use of medicines
• Problems in using medication
• in subgroups of elderly population
• frail persons or persons with certain diseases
• persons in institutions
• with certain medicines
• anticholinergic activity /load
• sedative drugs

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The drugs developed for aged persons should be
studied more carefully in elderly persons