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Drugs & Aging

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https://www.readbyqxmd.com/read/29119468/clinical-decision-support-and-optional-point-of-care-testing-of-renal-function-for-safe-use-of-antibiotics-in-elderly-patients-a-retrospective-study-in-community-pharmacy-practice
#1
Mette Heringa, Annemieke Floor-Schreudering, Peter A G M De Smet, Marcel L Bouvy
OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a clinical decision support system (CDSS) for seven antibiotics. Alerts were generated during prescription processing in the case of previously registered renal impairment and when no information on renal function was available for patients aged 70 and over...
November 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29116600/recent-progress-in-the-pharmacotherapy-of-alzheimer-s-disease
#2
Rita Khoury, Kush Patel, Jake Gold, Stephanie Hinds, George T Grossberg
Alzheimer's disease is the most common major neurocognitive disorder with substantial social and economic impacts. This article is an update on current pharmacotherapy, advancements in biomarker use, and drugs in the pipeline for this disease. To date, no new drug has qualified to be added to the current therapeutic arsenal comprising cholinesterase inhibitors and the NMDA receptor antagonist memantine. Drugs in the pipeline include symptomatic therapies that are neurotransmitter-based, but mostly disease-modifying therapies...
November 7, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29110264/optimization-of-drug-prescription-and-medication-management-in-older-adults-with-cardiovascular-disease
#3
Nanette K Wenger, Caroline Lloyd Doherty, Jerry H Gurwitz, Glenn A Hirsch, Holly M Holmes, Matthew S Maurer, Michael D Murray
Cardiovascular disease increases incrementally with age and elderly patients concomitantly sustain multimorbidities, with resultant prescription of multiple medications. Despite conforming with disease-specific cardiovascular clinical practice guidelines, this polypharmacy predisposes many elderly individuals with cardiovascular disease to adverse drug events and non-adherence. Patient-centered care requires that the clinician explore with each patient his or her goals of care and that this shared decision-making constitutes the basis for optimization of medication management...
November 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29086232/the-potential-of-%C3%AE-hydroxy-%C3%AE-methylbutyrate-as-a-new-strategy-for-the-management-of-sarcopenia-and-sarcopenic-obesity
#4
REVIEW
Andrea P Rossi, Alessia D'Introno, Sofia Rubele, Cesare Caliari, Stefano Gattazzo, Elena Zoico, Gloria Mazzali, Francesco Fantin, Mauro Zamboni
Sarcopenia is defined as an age-related loss of skeletal muscle mass and function and is recognized as a major clinical problem for older people. Essential amino acid supplementation, particularly β-hydroxy-β-methylbutyrate (HMB), a metabolite of leucine that is produced in skeletal muscle, has been evaluated in several studies as a nutritional approach to enhancing muscle protein synthesis in healthy or frail elderly subjects. Studies performed in in vitro conditions show that HMB may be effective in the treatment of muscle wasting, increasing myogenesis, reducing muscle apoptosis, and having a positive effect on muscle protein turnover; however, studies of the effects of HMB conducted in old animals have reported conflicting results...
October 31, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29086350/underuse-of-anticoagulation-in-older-patients-with-atrial-fibrillation-and-chads2-score-%C3%A2-%C3%A2-2-are-we-doing-better-since-the-marketing-of-direct-oral-anticoagulants
#5
Séverine Henrard, Caroline Vandenabeele, Sophie Marien, Benoit Boland, Olivia Dalleur
OBJECTIVE: Our objectives were to (1) describe the evolution of the underuse of anticoagulants in older people with atrial fibrillation (AF) and a CHADS2 score ≥ 2 since direct oral anticoagulants (DOACs) were introduced to the market and (2) describe factors associated with this underuse. METHODS: We conducted a retrospective cross-sectional study including geriatric patients admitted during the pre-DOAC (2008-2011) and post-DOAC (2013-2015) periods in an academic hospital in Belgium...
October 30, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29086349/targeted-therapies-in-the-management-of-ovarian-cancer-a-focus-on-older-patients
#6
REVIEW
Caroline Lum, Christopher B Steer
Ovarian cancer is one of the most common gynaecological malignancies and one of the leading causes of cancer mortality in women. The standard of care for ovarian cancer is maximal de-bulking surgery followed by adjuvant platinum-based chemotherapy. The median age at diagnosis is 63 years, yet older patients are under-represented in clinical trials. Historically, 65 years of age has been used as a definition of elderly; however, such an age cut-off encompasses a highly heterogeneous population with regards to comorbidity, functional status, and cognition...
October 30, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28980156/pain-in-osteoporosis-from-pathophysiology-to-therapeutic-approach
#7
REVIEW
Antonino Catalano, Gabriella Martino, Nunziata Morabito, Claudia Scarcella, Agostino Gaudio, Giorgio Basile, Antonino Lasco
The high worldwide prevalence of osteoporosis means it is considered a serious public health concern, possibly leading to physical disability and an increased mortality rate. Although osteoporosis is known as a silent disease affecting aging populations, its primary symptom remains pain. Acute pain is reported by patients with osteoporosis-related fractures, but chronic pain, mainly back pain, is also a characteristic of severe osteoporosis. Pain is associated not only with fractures but also with bodily changes in patients with osteoporosis that may include sensory, affective, and cognitive aspects...
October 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28965331/post-transplant-viral-respiratory-infections-in-the-older-patient-epidemiology-diagnosis-and-management
#8
REVIEW
Nancy Law, Deepali Kumar
Organ and stem cell transplantation has been one of the greatest advances in modern medicine, and is the primary treatment modality for many end-stage diseases. As our population ages, so do the transplant recipients, and with that comes many new challenges. Respiratory viruses have been a large contributor to the mortality and morbidity of solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Respiratory viruses are generally a long-term complication of transplantation and primarily acquired in the community...
October 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28956283/the-effect-of-computerized-physician-order-entry-template-modifications-on-the-administration-of-high-risk-medications-in-older-adults-in-the-emergency-department
#9
Mitchell Kim, Stephen J Kaplan, Steven H Mitchell, Medley Gatewood, Itay Bentov, Katherine A Bennett, Carol A Crawford, Paul R Sutton, Diane Matsuwaka, Mamatha Damodarasamy, May J Reed
BACKGROUND: Older adults are more susceptible to adverse events when administered certain medications at doses appropriate for younger adults. OBJECTIVE: The aim of this study was to investigate the effect of default geriatric dosing on computerized physician order entry (CPOE) templates on the subsequent administration of recommended starting doses of opioids, benzodiazepines (BZDs) and non-steroidal anti-inflammatory drugs (NSAIDs) to older adults in the emergency department (ED)...
October 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28952130/repeat-adverse-drug-reaction-related-hospital-admissions-in-elderly-australians-a-retrospective-study-at-the-royal-hobart-hospital
#10
Nibu Parameswaran Nair, Leanne Chalmers, Bonnie J Bereznicki, Colin M Curtain, Luke R Bereznicki
BACKGROUND: Adverse drug reactions are a major cause of hospital admissions in older individuals, with the majority potentially preventable. Despite the apparent magnitude of this problem, little is known about rates of repeat admission to hospital as a result of adverse drug reactions. OBJECTIVES: The objectives of this study were to investigate the occurrence of repeat adverse drug reaction-related hospital admissions in elderly patients within 12 months of an adverse drug reaction-related admission to a medical ward and whether a validated adverse drug reaction score could be useful in identifying patients at higher risk of a repeat adverse drug reaction-related hospitalisation...
October 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28853000/discontinuation-of-preventive-medicines-in-older-people-with-limited-life-expectancy-a-systematic-review
#11
REVIEW
Sujita W Narayan, Prasad S Nishtala
BACKGROUND: In the presence of multimorbidity and limited life expectancy (LLE), the need for continued use of preventive medicines becomes uncertain as they may neither improve health nor confer continued health benefits. OBJECTIVE: Our objective was to systematically review the literature to examine the discontinuation of preventive medicines in older people with LLE. METHODS: A systematic literature search was conducted using the Ovid MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Central Register databases...
October 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28815461/drug-induced-kidney-injury-in-the-elderly
#12
REVIEW
Sana Khan, Valentina Loi, Mitchell H Rosner
The incidence of acute kidney injury in the elderly has grown over the past decade. One of the primary drivers is drug-induced nephrotoxicity, which is the result of a combination of the unique susceptibilities to kidney injury and the increased use of medications in the elderly population. Specific drug classes are associated with increased rates of kidney injury including agents that block the renin angiotensin system, antimicrobials, and chemotherapeutic agents. Mechanistically, injury may be due to hemodynamic effects, tubular or glomerular toxicity, and interstitial nephritis...
October 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28801707/association-between-anticholinergic-drug-use-and-health-related-quality-of-life-in-community-dwelling-older-adults
#13
Benoit Cossette, Maimouna Bagna, Modou Sene, Caroline Sirois, Gabrielle P Lefebvre, Olivier Germain, José A Morais, Pierrette Gaudreau, Hélène Payette
BACKGROUND: The use of drugs with anticholinergic properties (AC drugs) has been associated with decreased functioning and impaired cognition in older adults. Studies assessing the association between AC-drug use and health-related quality of life (HRQoL) show conflicting results. OBJECTIVE: The aim was to evaluate the association between AC-drug use and HRQoL in community-dwelling older adults. METHODS: The NuAge cohort study enrolled 1793 men and women aged 68-82 years...
October 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28861727/managing-idiopathic-pulmonary-fibrosis-which-drug-for-which-patient
#14
Conal Hayton, Nazia Chaudhuri
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with high mortality. Two novel antifibrotic agents, pirfenidone and nintedanib, have received licences for use in IPF in recent years. Phase III, multinational, randomised control trials have provided evidence that both drugs reduce decline in forced vital capacity (FVC) over time, while further post hoc studies have suggested that both pirfenidone and nintedanib can be efficacious, regardless of age and severity of baseline lung function...
September 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28808946/perioperative-care-of-elderly-surgical-outpatients
#15
REVIEW
Xuezhao Cao, Paul F White, Hong Ma
The ambulatory setting offers potential advantages for elderly patients undergoing elective surgery due to the advancement in both surgical and anesthetic techniques resulting in quicker recovery times, fewer complications, higher patient satisfaction, and reduced costs of care. This review article aims to provide a practical guide to anesthetic management of elderly outpatients. Important considerations in the preoperative evaluation of elderly outpatients with co-existing diseases, as well as the advantages and disadvantages of different anesthetic techniques on a procedural-specific basis, and recommendations regarding the management of common postoperative complications (e...
September 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28801750/cutaneous-drug-reactions-in-the-elderly
#16
REVIEW
James W S Young, Neil H Shear
Cutaneous adverse drug reactions comprise a significant proportion of all adverse drug reactions. They may mimic other dermatologic or systemic illnesses and may cause significant morbidity or mortality. Seven morphologic groups encompass the most commonly encountered cutaneous drug reaction syndromes: exanthematous (maculopapular), dermatitic/eczematous, urticarial, pustular, blistering, purpuric, and erythrodermic. Drug reactions may have significant downstream consequences for the older individual.
September 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28776209/potentially-inappropriate-medications-and-the-time-to-full-functional-recovery-after-hip-fracture
#17
Andrea Iaboni, Kerri Rawson, Craig Burkett, Eric J Lenze, Alastair J Flint
BACKGROUND: Older adults after hip fracture are at increased risk of being prescribed potentially inappropriate medications, and may be particularly vulnerable to their adverse effects. OBJECTIVE: The objective of this study was to examine the association of potentially inappropriate medication use with the time to full functional recovery within 1 year of hip fracture repair. METHODS: We conducted a secondary analysis of a prospective longitudinal study of eight hospitals in St...
September 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28752503/trends-in-drug-prescription-rates-for-dementia-an-observational-population-based-study-in-france-2006-2014
#18
Mathilde François, Jonathan Sicsic, Alexis Elbaz, Nathalie Pelletier Fleury
BACKGROUND: Since the 2011 French guidance updates, cholinesterase inhibitors and memantine are considered optional in the management of dementia and leave physicians free to prescribe based on their clinical expertise. OBJECTIVES: The aims of this study were to analyze the influence of these recent guidance updates on the prescription rates of these drugs and to quantify the impact of potential changes on healthcare expenditures. METHODS: Patients over 65 years old from a representative sample of a national administrative claims database, the French national health insurance database, were retrospectively included from 2006 to 2014...
September 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28702928/underuse-of-oral-anticoagulants-and-inappropriate-prescription-of-antiplatelet-therapy-in-older-inpatients-with-atrial-fibrillation
#19
Lorette Averlant, Grégoire Ficheur, Laurie Ferret, Stéphane Boulé, François Puisieux, Michel Luyckx, Julien Soula, Alexandre Georges, Régis Beuscart, Emmanuel Chazard, Jean-Baptiste Beuscart
BACKGROUND: Several studies have shown that the prescription of antiplatelet therapy (APT) is associated with an increased risk of oral anticoagulant (OAC) underuse in patients aged 75 years and over with atrial fibrillation (AF). An associated atheromatous disease may be the underlying reason for APT prescription. The objective of the study was to determine whether the association between underuse of OAC and APT prescription was explained by the presence of an atheromatous disease. METHODS AND RESULTS: We performed a retrospective, observational, single-centre study between 2009 and 2013 based on administrative data...
September 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28656508/risk-of-mortality-associated-with-anticholinergic-use-in-elderly-nursing-home-residents-with-depression
#20
Satabdi Chatterjee, Vishal Bali, Ryan M Carnahan, Hua Chen, Michael L Johnson, Rajender R Aparasu
BACKGROUND: Few studies have evaluated the association between anticholinergic use and mortality in elderly nursing home residents. OBJECTIVE: The aim of this study was to examine the risk of mortality associated with anticholinergic use among elderly nursing home residents with depression. METHODS: The study employed a population-based nested case-control design using 2007-2010 Minimum Data Set (MDS)-linked Medicare data from all states. The base cohort included Medicare beneficiaries aged ≥65 years, diagnosed with depression as of 2007, and with any MDS assessment in 2007...
September 2017: Drugs & Aging
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