安徽医科大学：《临床药理学 Clinical Pharmacology》课程教学资源（授课教案，英文版）Charpter 24 Drug therapy in the elderly

安徽医科大学国际教育学院教案与讲稿 Teaching Plan for International Students,AHMU Title of the course:Drug therapy in the elderly Chapter:24 Teacher's name: Chang Yan Grade:2013 Department:Clinical Medicine,School of International Education Time:14:30-16:50 Date(DM/Y):3/30/2016 To master: Teaching (1)Pharmacokinetic features of elderly Objectives; (2)Principle of drug use of elderly Teaching Familiar with: Requirements (1)Physiological and pathological features of elderly (1)Physiological and pathological features of elderly Teaching (2)Age-related changes in Pharmacokinetic Content (3)Age-related changes in effector system function (4)Drug groups for which age confers increased risk for toxicity Teaching Teaching Focus: Focus; (1)Age-related changes in Pharmacokinetic Difficult problems and their Solutions: Difficult Problems (1)Drug groups for which age confers increased risk for toxicity and their (2)Take various teaching models and give some exmples Solutions (1)Physiological and pathological features of elderly 5min Time (2)Pharmacokinetic features of elderly 15 min Allotment (3)Give some drugs excreted by kidney 10 min (4)General principle of drug use of elderly 10 min (1)The physiological and pathological changes Assignment (2)Pharmacokinetic changes in the elderly (3)The Medication the general principle in the elderly (1)Principle of Clinical Pharmacology(Second Edition);ArthurJ.Atkinson (2)Basic Clinical Pharmacology;Bertram G Katzung Reference (3)Oxford Textbook of Clinical Pharmacology and Drug Therapy;David Text Grahame-Smith,Jeffrey Aronson (4)《临床药理学》（第四版）人民卫生出版社：李俊主编 Memo 1

安徽医科大学国际教育学院教案与讲稿 1 Teaching Plan for International Students, AHMU Title of the course: Drug therapy in the elderly Chapter: 24 Teacher’s name: Chang Yan Grade: 2013 Department: Clinical Medicine, School of International Education Time: 14:30—16:50 Date (D/M/Y): 3/30/2016 Teaching Objectives; Teaching Requirements To master: (1) Pharmacokinetic features of elderly (2) Principle of drug use of elderly Familiar with: (1) Physiological and pathological features of elderly Teaching Content (1) Physiological and pathological features of elderly (2) Age-related changes in Pharmacokinetic (3) Age-related changes in effector system function (4) Drug groups for which age confers increased risk for toxicity Teaching Focus; Difficult Problems and their Solutions Teaching Focus: (1) Age-related changes in Pharmacokinetic Difficult problems and their Solutions: (1) Drug groups for which age confers increased risk for toxicity (2) Take various teaching models and give some exmples Time Allotment (1) Physiological and pathological features of elderly 5 min (2) Pharmacokinetic features of elderly 15 min (3) Give some drugs excreted by kidney 10 min (4) General principle of drug use of elderly 10 min Assignment (1)The physiological and pathological changes (2) Pharmacokinetic changes in the elderly (3) The Medication the general principle in the elderly Reference Text (1) Principle of Clinical Pharmacology (Second Edition); ArthurJ. Atkinson (2) Basic & Clinical Pharmacology; Bertram G. Katzung (3) Oxford Textbook of Clinical Pharmacology and Drug Therapy; David Grahame-Smith, Jeffrey Aronson (4)《临床药理学》（第四版）人民卫生出版社；李俊 主编 Memo

安徽医科大学国际教育学院教案与讲稿 Teaching Plan for International Students,AHMU Title of the course:Drug therapy in the elderly Chapter:24 Teacher's name: Chang Yan Grade:2013 Department:Clinical Medicine.School of International Education Time:14:30-16:50 Date(DM/Y):3/30/2016 Lecture Notes: 【Features of Aging】 5min Physiological changes Example-Alterations in Cardiovascular System of the Elderly Cardiovasular hemodynamics Tendency to contracted intravascular volume Increased peripheral vascular resistance Tendency to lowered cardiac output Decreased baroreceptor sensitivity Increased blood pressure variability Suppressed plasma renin activity Decreased vascular endothelium production of nitric oxide Pathological changes-Age-related chronic medical conditions Medical Condition Frequency Per 1000 Persons in USA Age 65y Arthritis 30 241 481 Hypertension 129 244 372 Hearing impairment 37 141 321 Heart disease 31 134 295 Diabetes 9 57 99 Visual impairment 19 48 79 Cerebrovascular disease 16 63 Constipation 11 19 60 2

安徽医科大学国际教育学院教案与讲稿 2 Teaching Plan for International Students, AHMU Title of the course: Drug therapy in the elderly Chapter: 24 Teacher’s name: Chang Yan Grade: 2013 Department: Clinical Medicine, School of International Education Time: 14:30—16:50 Date (D/M/Y): 3/30/2016 Lecture Notes: 【Features of Aging】 5 min Physiological changes Example - Alterations in Cardiovascular System of the Elderly Cardiovasular hemodynamics
Tendency to contracted intravascular volume
Increased peripheral vascular resistance
Tendency to lowered cardiac output
Decreased baroreceptor sensitivity
Increased blood pressure variability
Suppressed plasma renin activity
Decreased vascular endothelium production of nitric oxide Pathological changes- Age-related chronic medical conditions Medical Condition Frequency Per 1000 Persons in USA Age 65 y Arthritis 30 241 481 Hypertension 129 244 372 Hearing impairment 37 141 321 Heart disease 31 134 295 Diabetes 9 57 99 Visual impairment 19 48 79 Cerebrovascular disease 1 16 63 Constipation 11 19 60

安微医科大学国际教育学院教案与讲稿 【Pharmacokinetic Changes in the Elderly】 15 min Gastrointestinal Absorption none Drug Distribution Central Compartment Volume none or v Peripheral Compartment Volume Lipophilic Drugs ▲△ Hydrophilic Drugs Plasma Protein Binding Binding to Albumin v Binding to a 1-acid Glycoprotein none or▲ Drug Elimination Renal Elimination Hepatic Elimination Phase I Reactions CYP3A CYP1A2,2D6,2C9,2C19,2E1 none or Phase IⅡReactions Glucuronidation none Sulfation none Acetylation none Partial List of Drugs That Undergo Significant Renal Excretion in Humans] 10 min Amantadine(金刚烷胺)Aminoglycoside antibiotics(氨基苷类抗生素) Tetracycline(四环素)Quinidine(奎尼丁) Lithium（(锂盐)Digoxin(地高辛) Nitrofurantoin(呋喃妥因)Penicillin antibiotics(青霉素) Cimetidine(甲氰米胍)Furosemide(速尿，呋塞米) Sulfonamides(磺胺类)Phenobarbital(苯巴比妥) 【The Medication the General Principle】 10 min The efficacy and safety Dosage regimen Choice of Drugs Improve compliance Dosage choice Time choice of drug use 3

安徽医科大学国际教育学院教案与讲稿 3 【Pharmacokinetic Changes in the Elderly】 15 min Gastrointestinal Absorption none Drug Distribution Central Compartment Volume none or ▼ Peripheral Compartment Volume Lipophilic Drugs ▲▲ Hydrophilic Drugs ▼▼ Plasma Protein Binding Binding to Albumin ▼ Binding to α1-acid Glycoprotein none or ▲ Drug Elimination Renal Elimination ▼▼ Hepatic Elimination Phase I Reactions CYP3A ▼ CYP1A2,2D6,2C9,2C19,2E1 none or ▼ Phase II Reactions Glucuronidation none Sulfation none Acetylation none 【Partial List of Drugs That Undergo Significant Renal Excretion in Humans】 10 min Amantadine（金刚烷胺）Aminoglycoside antibiotics（氨基苷类抗生素） Tetracycline（四环素）Quinidine（奎尼丁） Lithium（锂盐）Digoxin（地高辛） Nitrofurantoin（呋喃妥因）Penicillin antibiotics（青霉素） Cimetidine（甲氰米胍）Furosemide（速尿，呋塞米） Sulfonamides（磺胺类）Phenobarbital（苯巴比妥） 【The Medication the General Principle】 10 min The efficacy and safety Dosage regimen Choice of Drugs Improve compliance Dosage choice Time choice of drug use