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Drugs & Aging

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https://www.readbyqxmd.com/read/29744750/treatment-of-urothelial-cancer-in-elderly-patients-focus-on-immune-checkpoint-inhibitors
#1
REVIEW
Gray Jodon, Stacy M Fischer, Elizabeth R Kessler
Urothelial carcinoma, or bladder cancer, is a malignancy that most commonly affects older patients. The median age at diagnosis is 73 years, and care of these patients requires consideration not just of the disease-related factors such as stage and histology, but also of patient-related factors. Many of these patients have concurrent medical morbidities and additional changes related to the aging process. Older patients with cancer are a unique population requiring additional considerations and assessment in treatment decision-making...
May 9, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29737468/potential-drug-drug-interactions-in-a-cohort-of-elderly-polymedicated-primary-care-patients-on-antithrombotic-treatment
#2
Katharina Luise Schneider, Kathrin Kastenmüller, Klaus Weckbecker, Markus Bleckwenn, Miriam Böhme, Julia Carolin Stingl
INTRODUCTION: Drug-drug interactions (DDIs) are an important risk factor for adverse drug reactions. Older, polymedicated patients are particularly affected. Although antithrombotics have been detected as high-risk drugs for DDIs, data on older patients exposed to them are scarce. METHODS: Baseline data of 365 IDrug study outpatients (≥ 60 years, use of an antithrombotic and one or more additional long-term drug) were analyzed regarding potential drug-drug interactions (pDDIs) with a clinical decision support system...
May 8, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29736816/pre-exposure-prophylaxis-for-hiv-infection-in-the-older-patient-what-can-be-recommended
#3
Iacopo Franconi, Giovanni Guaraldi
Over the past 15 years, a significant increase in new HIV/AIDS diagnoses has been observed in the elderly population. This new epidemiological shift has been attributed to a longer sex life, lifestyle and changes in sexual behavior, poor sexual health education, and misconceptions about the absence of sexually transmitted disease in later life. Although many biomedical and behavioral interventions have proven useful to prevent sexually transmitted infections and HIV, pre-exposure prophylaxis (PrEP) has been shown to be the most successful biomedical intervention to prevent HIV in high-risk individuals...
May 8, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29736815/anticholinergic-drug-burden-tools-scales-and-adverse-outcomes-in-different-clinical-settings-a-systematic-review-of-reviews
#4
REVIEW
Tomas J Welsh, Veronika van der Wardt, Grace Ojo, Adam L Gordon, John R F Gladman
BACKGROUND: Cumulative anticholinergic exposure (anticholinergic burden) has been linked to a number of adverse outcomes. To conduct research in this area, an agreed approach to describing anticholinergic burden is needed. OBJECTIVE: This review set out to identify anticholinergic burden scales, to describe their rationale, the settings in which they have been used and the outcomes associated with them. METHODS: A search was performed using the Healthcare Databases Advanced Search of MEDLINE, EMBASE, Cochrane, CINAHL and PsycINFO from inception to October 2016 to identify systematic reviews describing anticholinergic burden scales or tools...
May 8, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29736814/dabigatran-levels-in-elderly-patients-with-atrial-fibrillation-first-post-marketing-experiences
#5
Tomáš Bolek, Matej Samoš, Ingrid Škorňová, Lucia Stančiaková, Ján Staško, Peter Galajda, Peter Kubisz, Marián Mokáň
BACKGROUND: The number of elderly individuals with non-valvular atrial fibrillation (NV-AF) requiring long-term anticoagulation is rising. The pharmacokinetics of oral anticoagulants in elderly individuals may differ from that for younger patients. The aim of this study was to assess the dabigatran levels in elderly patients with NV-AF. PATIENTS AND METHODS: A pilot prospective post-marketing study in patients with NV-AF on dabigatran therapy was performed; we enrolled 21 consecutive elderly patients (aged ≥ 75 years) on a reduced dabigatran regimen (110 mg twice daily) and compared them with 13 younger (≤ 70 years) individuals on reduced dabigatran therapy due to renal impairment and with 16 younger patients on standard dabigatran therapy (150 mg twice daily)...
May 8, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29725986/efficacy-and-safety-of-analgesic-treatment-for-depression-in-people-with-advanced-dementia-randomised-multicentre-double-blind-placebo-controlled-trial-dep-pain-dem
#6
Ane Erdal, Elisabeth Flo, Dag Aarsland, Clive Ballard, Dagrun D Slettebo, Bettina S Husebo
BACKGROUND: Chronic pain and depression often co-occur, and pain may exacerbate depression in people with dementia. OBJECTIVE: The objective of this study was to assess the efficacy and safety of analgesic treatment for depression in nursing home patients with advanced dementia and clinically significant depressive symptoms. METHODS: We conducted a multicentre, parallel-group, double-blind, placebo-controlled trial in 47 nursing homes, including 162 nursing home patients aged ≥ 60 years with dementia (Mini-Mental State Examination ≤ 20) and depression (Cornell Scale for Depression in Dementia ≥ 8)...
May 3, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29705831/deprescribing-benzodiazepines-in-older-patients-impact-of-interventions-targeting-physicians-pharmacists-and-patients
#7
REVIEW
Brendan J Ng, David G Le Couteur, Sarah N Hilmer
Benzodiazepines (BZDs; including the related Z-drugs) are frequently targets for deprescribing; long-term use in older people is harmful and often not beneficial. BZDs can result in significant harms, including falls, fractures, cognitive impairment, car crashes and a significant financial and legal burden to society. Deprescribing BZDs is problematic due to a complex interaction of drug, patient, physician and systematic barriers, including concern about a potentially distressing but rarely fatal withdrawal syndrome...
April 28, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29704191/morning-stiffness-in-elderly-patients-with-rheumatoid-arthritis-what-is-known-about-the-effect-of-biological-and-targeted-agents
#8
Chi Chiu Mok
Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects all age groups, but the prevalence appears to increase with age. Elderly-onset RA (after the age of 60 years) has distinct clinical patterns. Treatment of RA in older individuals is confounded by the presence of medical comorbidities, concurrent medications, drug interactions, and the altered pharmacokinetics and pharmacodynamics related to aging and organ dysfunction. Patients with RA commonly experience morning stiffness, which is associated with reduced quality of life and work disability...
April 27, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29671214/clinical-pharmacy-services-on-geriatric-care-wards-catch-22-of-implementation-and-research
#9
LETTER
Lorenz Van der Linden, Julie Hias, Karolien Walgraeve, Johan Flamaing, Isabel Spriet, Jos Tournoy
No abstract text is available yet for this article.
April 18, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29663152/a-glimpse-into-uveitis-in-the-aging-eye-pathophysiology-clinical-presentation-and-treatment-considerations
#10
REVIEW
Elizabeth Akinsoji, Raquel Goldhardt, Anat Galor
Uveitis describes a group of inflammatory conditions of the eye that have various underlying causes and clinical presentations. Susceptibilities to uveitis in the elderly may be attributed to age-related risk factors such as immunosenescence, increased immunological inflammatory mediators, and autoimmunity. Overall, anterior uveitis is more common than posterior and panuveitis in the general population and also in the elderly. Some causes of uveitis in the elderly are herpes simplex virus, ocular ischemic syndrome, sarcoidosis, and central nervous system lymphoma, and these will be discussed in detail herein...
April 16, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29663151/inappropriate-use-of-antimicrobials-for-lower-respiratory-tract-infections-in-elderly-patients-patient-and-community-related-implications-and-possible-interventions
#11
Inger van Heijl, Valentijn A Schweitzer, Lufang Zhang, Paul D van der Linden, Cornelis H van Werkhoven, Douwe F Postma
The elderly are more susceptible to infections, which is reflected in the incidence and mortality of lower respiratory tract infections (LRTIs) increasing with age. Several aspects of antimicrobial use for LRTIs in elderly patients should be considered to determine appropriateness. We discuss possible differences in microbial etiology between elderly and younger adults, definitions of inappropriate antimicrobial use for LRTIs currently found in the literature, along with their results, and the possible negative impact of antimicrobial therapy at both an individual and community level...
April 16, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29651640/characteristics-of-new-onset-and-chronic-sleep-medication-users-among-older-adults-a-retrospective-study-of-a-us-medigap-plan-population-using-propensity-score-matching
#12
Shirley Musich, Shaohung S Wang, Luke B Slindee, Lynn Saphire, Ellen Wicker
BACKGROUND: Prescription sleep medications are often utilized to manage sleep problems among older adults even though these drugs are associated with multiple risks. OBJECTIVE: The aim was to determine the prevalence and characteristics of new-onset compared to chronic sleep medication users and to examine factors associated with the conversion from new to chronic use. A secondary objective was to investigate the impact of sleep medications on health outcomes of injurious falls and patterns of healthcare utilization and expenditures...
April 12, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29651639/abatacept-for-treatment-of-rheumatoid-arthritis-special-focus-on-the-elderly
#13
Martin Soubrier, Clement Lahaye, Zuzana Tatar
Targeted therapies have been developed for patients with rheumatoid arthritis (RA) for whom prior treatment with traditional disease-modifying anti-rheumatic drugs has failed. The numerous different signaling pathways now targeted by various classes of monoclonal antibodies and small molecule inhibitors may complicate treatment decisions. Abatacept selectively modulates a co-stimulatory signal necessary for T-cell activation. Thus, abatacept is effective in biologic-naive patients and in those for whom biologic therapy has failed...
April 12, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29589223/an-analysis-of-the-inclusion-of-medications-considered-potentially-inappropriate-in-older-adults-in-chemotherapy-templates-for-hematologic-malignancies-one-recommendation-for-all
#14
Amy Zhou, Holly M Holmes, Arti Hurria, Tanya M Wildes
BACKGROUND: There remains a paucity of data regarding the use of potentially inappropriate medications (PIMs) in the supportive management of older adults undergoing chemotherapy. Raising awareness among healthcare providers regarding the frequency of their use and potential toxicities may help to minimize the risks to patients. OBJECTIVE: The aim of this study was to evaluate the frequency of six specific classes of medications considered PIMs by the American Geriatrics Society Beers Criteria that are commonly included in the National Comprehensive Cancer Network (NCCN) chemotherapy order templates for hematologic malignancies...
March 27, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29582403/medications-and-prescribing-patterns-as-factors-associated-with-hospitalizations-from-long-term-care-facilities-a-systematic-review
#15
REVIEW
Kate N Wang, J Simon Bell, Esa Y H Chen, Julia F M Gilmartin-Thomas, Jenni Ilomäki
BACKGROUND: Residents of long-term care facilities (LTCFs) are at high risk of hospitalization. Medications are a potentially modifiable risk factor for hospitalizations. OBJECTIVE: Our objective was to systematically review the association between medications or prescribing patterns and hospitalizations from LTCFs. METHODS: We searched MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and International Pharmaceutical Abstracts (IPA) from inception to August 2017 for longitudinal studies reporting associations between medications or prescribing patterns and hospitalizations...
March 26, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29569174/relationship-between-organizational-culture-and-the-use-of-psychotropic-medicines-in-nursing-homes-a-systematic-integrative-review
#16
REVIEW
Mouna Sawan, Yun-Hee Jeon, Timothy F Chen
BACKGROUND: Psychotropic medicines are commonly used in nursing homes, despite marginal clinical benefits and association with harm in the elderly. Organizational culture is proposed as a factor explaining the high-level use of psychotropic medicines. Schein describes three levels of culture: artifacts, espoused values, and basic assumptions. OBJECTIVE: This integrative review aimed to investigate the facets and role of organizational culture in the use of psychotropic medicines in nursing homes...
March 22, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29557059/novel-treatments-for-multiple-myeloma-what-role-do-they-have-in-older-adults
#17
REVIEW
Hira S Mian, Tanya M Wildes
Multiple myeloma is a malignant plasma cell disease, which typically affects older patients, with a median age at diagnosis of 70 years. The recent introduction of novel drugs and ongoing improvements in supportive care have significantly contributed to overall better management and outcomes for patients with multiple myeloma. Autologous stem-cell transplantation has been a standard part of therapy for myeloma patients for many years, first in younger patients and increasingly in older, and may still be considered in selected older patients with myeloma...
March 19, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29564755/choice-and-outcomes-of-rate-control-versus-rhythm-control-in-elderly-patients-with-atrial-fibrillation-a-report-from-the-reposi-study
#18
Francesco Paciullo, Marco Proietti, Vanessa Bianconi, Alessandro Nobili, Matteo Pirro, Pier Mannuccio Mannucci, Gregory Y H Lip, Graziana Lupattelli
BACKGROUND: Among rate-control or rhythm-control strategies, there is conflicting evidence as to which is the best management approach for non-valvular atrial fibrillation (AF) in elderly patients. DESIGN: We performed an ancillary analysis from the 'Registro Politerapie SIMI' study, enrolling elderly inpatients from internal medicine and geriatric wards. METHODS: We considered patients enrolled from 2008 to 2014 with an AF diagnosis at admission, treated with a rate-control-only or rhythm-control-only strategy...
April 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29546609/igg4-related-disease-beyond-glucocorticoids
#19
REVIEW
Mitsuhiro Akiyama, Tsutomu Takeuchi
IgG4-related disease is a heterogeneous immune-mediated fibroinflammatory condition that can affect every single organ. This disease is more prevalent in the elderly (the mean age of patients is above 60 years) and the prevalence rate is estimated to be over 4.6 per 100,000 population. Before making a diagnosis, the exclusion of malignancies, lymphoma, anti-neutrophil cytoplasmic antibody-associated vasculitis, multicentric Castleman disease, and other mimickers is crucial for appropriate treatment. Broad management guidelines have been published emphasizing the need for prompt treatment and the use of glucocorticoids as first-line drug therapy for induction of remission...
April 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29541966/impact-of-deprescribing-interventions-in-older-hospitalised-patients-on-prescribing-and-clinical-outcomes-a-systematic-review-of-randomised-trials
#20
REVIEW
Janani Thillainadesan, Danijela Gnjidic, Sarah Green, Sarah N Hilmer
BACKGROUND: Polypharmacy and potentially inappropriate medications (PIMs) are prevalent in older adults in hospital, and are associated with negative outcomes including adverse drug reactions, falls, confusion, hospitalisation and death. Deprescribing may reduce inappropriate polypharmacy and use of inappropriate medications. OBJECTIVE: The aim of this systematic review was to investigate the efficacy of deprescribing interventions in older inpatients to reduce PIMs and impact on clinical outcomes...
April 2018: Drugs & Aging
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