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Gender, age, genetics


Gender, age, genetics:
• Women have more fat and less water, thus differing volumes of distribution of lipophilic and hydrophilic drugs
• With aging in both sexes, there is an increase in body fat, decreased cardiac output, and liver perfusion
• Cytochrome oxidase systems are more active in women and plasma clearance differs
• Women have accelerated gastric motility
• Women are slower in induction and emergence due to larger fat stores
• Women have a lower pain threshold and describe pain better
• Women have a higher incidence of conditions that cause pain
• Women experience more pain due to a difference in opioid receptor activation
• The pain threshold varies in women with the menstrual cycle
• Response to opioid pain medications is different in women due to larger fat stores and lower plasma concentration
• Male hormones seem to prevent the development of chronic pain
• Progesterone makes visceral and peripheral nerves less sensitive to local anesthetics
• Lidocaine’s half-life is shorter and renal clearance is higher in women
• Women require 30% higher doses of morphine and experience more respiratory depression
• Women are more sensitive to kappa-opioids and they have a shorter half-life in men
• Women are 30% less sensitive to Propofol
• Women dream more frequently during anesthesia
• Women are more sensitive to muscle relaxants (longer duration of action)
• Women have more adverse allergic reactions to anesthetics
• Women report more pain during Rocuronium injection
• Women have a much higher incidence of PONV
• Insomnia affects 57% of women, and they use much more sleep medication
• Women are more prone to addiction to alcohol, nicotine, cocaine, and ecstasy
• Women use many more herbs and alternative drugs
• Women are at higher risk for bleeding from thrombolytics

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