Skip to main content

The Pharmacokinetics and Pharmacodynamics of Drugs in Elderly Cachectic (Cancer) Patients

  • Chapter
Cachexia and Wasting: A Modern Approach

Abstract

The word cachexia is derived from the Greek words kakòs, meaning ‘bad,’ and hexis, meaning ‘condition’ [1]. From an epidemiological point of view, while patients with haematological malignancies and breast cancer seldom have this syndrome, most other solid tumours are associated with a high frequency of cachexia [2]. Indeed, its prevalence increases from 50% to more than 80% before death, and in more than 20% of patients cachexia is the main cause of death [3].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Tisdale MJ (1997) Biology of cachexia. J Natl Cancer Inst 89:1763–1773

    Article  PubMed  CAS  Google Scholar 

  2. Inui A (2002) Cancer anorexia-cachexia syndrome: current issues in research and management. CA Cancer J Clin 52:72–91

    Article  PubMed  Google Scholar 

  3. Bruera E (1997) Anorexia, cachexia and nutrition. BMJ 315:1219–1222

    PubMed  CAS  Google Scholar 

  4. Yancik R (1997) Cancer burden in the aged: an epidemiological and demographic overview. Cancer 80:1273–1283

    Article  PubMed  CAS  Google Scholar 

  5. Wildiers H, Highley MS, dei Bruijn EA et al (2003) Pharmacology of anticancer drugs in the elderly population. Clin Pharmacokinet 42:1–30

    Article  Google Scholar 

  6. Tisdale MJ (2000) Metabolic abnormalities in cachexia and anorexia. Nutrition 16:1013–1014

    Article  PubMed  CAS  Google Scholar 

  7. Kotler DP (2000) Cachexia. Ann Intern Med 133:622–634

    PubMed  CAS  Google Scholar 

  8. Vestal RE (1997) Aging and pharmacology. Cancer 80:1302–1310

    Article  PubMed  CAS  Google Scholar 

  9. Skirvin JA, Lichtman SM (2002) Pharmacokinetic considerations of oral chemotherapy in elderly patients with cancer. Drugs Aging 19:25–42

    Article  PubMed  CAS  Google Scholar 

  10. Raghuram TC, Krishnasvamy K (1981) Tetracycline absorption in malnutrition. Drug Nutr Interact 1:23–29

    PubMed  CAS  Google Scholar 

  11. Lichtman SM, Skirvin JA (2000) Pharmacology of antineoplastic agents in older cancer patients. Oncology 14:1743–1763

    PubMed  CAS  Google Scholar 

  12. Mangoni AA, Jackson SH (2004) Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol 57:6–14

    Article  PubMed  CAS  Google Scholar 

  13. Schrijvers D, Highley M, De Bruyn E et al (1999) Role of red blood cells in pharmacokinetics of chemotherapeutic agents. Anticancer Drugs 10:147–153

    Article  PubMed  CAS  Google Scholar 

  14. Sotaniemi EA, Arranto AJ, Pelkonen O et al (1997) Age and cytochrome P450-Iinked drug metabolism in humans: an analysis of 226 subjects with equal histopathologic conditions. Clin Pharm Ther 61:331–339

    Article  CAS  Google Scholar 

  15. Corcoran MB (1998) Polypharmacy in the older patient. In: Balducci L, Lyman GH, Ershler WB Comprehensive geriatric oncology. Harwood Academic Publishers, London, pp 525–532

    Google Scholar 

  16. John V, Mashru S, Lichtman J (2003) Pharmacological factors influencing anticancer drug selection in the el-derly. Drugs Aging 20:737–759

    Article  PubMed  CAS  Google Scholar 

  17. Jorquera F, Culebras DM, Gonzalezgallego J (1996) Influence of nutrition on liver oxidative metabolism. Nutrition 12:442–447

    Article  PubMed  CAS  Google Scholar 

  18. Sadean MR, Glass PS (2003) Pharmacokinetics in the elderly. Best Pract Res Clin Anaesthesiol 17:191–205

    Article  PubMed  CAS  Google Scholar 

  19. Kintzel PE, Dorr RT (1995) Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Cancer Treat Rev 21:33–64

    Article  PubMed  CAS  Google Scholar 

  20. Gurney H (1996) Dose calculation of anticancer drugs: a review of the current practice and introduction of an alternative. J Clin Oncol 14:2590–2611

    PubMed  CAS  Google Scholar 

  21. Vuyk J (2003) Pharmacodynamics in the elderly. Best Pract Res Clin Anaesthesiol 17:207–218

    Article  PubMed  CAS  Google Scholar 

  22. Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41

    Article  PubMed  CAS  Google Scholar 

  23. Kinzel PE, Dorr RT (1995) Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Cancer Treat Rev 21:33–64

    Article  Google Scholar 

  24. Koren G, Beatty K, Seto A et al (1992) The effects of impaired liver function on the elimination of antineoplastic agents. Ann Pharmacother 26:363–371

    PubMed  CAS  Google Scholar 

  25. Balducci L, Extermann M (1997) Cancer chemotherapy in the older patient: what the medical oncologist needs to know. Cancer 80:1317–1322

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer-Verlag Italia

About this chapter

Cite this chapter

Cova, D., Lorusso, V., Silvestris, N. (2006). The Pharmacokinetics and Pharmacodynamics of Drugs in Elderly Cachectic (Cancer) Patients. In: Mantovani, G., et al. Cachexia and Wasting: A Modern Approach. Springer, Milano. https://doi.org/10.1007/978-88-470-0552-5_37

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-0552-5_37

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0471-9

  • Online ISBN: 978-88-470-0552-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics