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Adverse drug reactions in the elderly

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https://www.readbyqxmd.com/read/28212616/general-practitioners-views-on-long-term-prescription-and-use-of-problematic-and-potentially-inappropriate-medication-for-oldest-old-patients-a-qualitative-interview-study-with-gps-cim-triad-study
#1
Nadine Janis Pohontsch, Kathrin Heser, Antje Löffler, Britta Haenisch, Debora Parker, Tobias Luck, Steffi G Riedel-Heller, Wolfgang Maier, Frank Jessen, Martin Scherer
BACKGROUND: Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM. METHODS: As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list)...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28174512/allergic-diseases-in-the-elderly-biological-characteristics-and-main-immunological-and-non-immunological-mechanisms
#2
REVIEW
Maria Teresa Ventura, Nicola Scichilone, Roberto Paganelli, Paola Lucia Minciullo, Vincenzo Patella, Matteo Bonini, Giovanni Passalacqua, Carlo Lombardi, Livio Simioni, Erminia Ridolo, Stefano R Del Giacco, Sebastiano Gangemi, Giorgio Walter Canonica
Life expectancy and the number of elderly people are progressively increasing around the world. Together with other pathologies, allergic diseases also show an increasing incidence in geriatric age. This is partly due to the growing emphasis on a more accurate and careful diagnosis of the molecular mechanisms that do not allow to ignore the real pathogenesis of many symptoms until now unknown, and partly to the fact that the allergic people from 20 years ago represent the elderly population now. Moreover, environmental pollution predisposes to the onset of allergic asthma and dermatitis which are the result of internal pathologies more than the expression of allergic manifestations...
2017: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/28107773/safety-and-effectiveness-of-tofogliflozin-in-elderly-japanese-patients-with-type-2-diabetes-mellitus-a-post-marketing-study-j-step-el-study
#3
Kazunori Utsunomiya, Naoki Shimmoto, Masayuki Senda, Yuji Kurihara, Ryoji Gunji, Shoko Fujii, Seigo Kakiuchi, Hisataka Fujiwara, Hiroyuki Kameda, Masahiro Tamura, Kohei Kaku
AIMS/INTRODUCTION: While sodium glucose cotransporter 2 inhibitors are a promising treatment for type 2 diabetes mellitus, they are associated with concerns about specific adverse drug reactions. We conducted a 1-year post-marketing study of tofogliflozin, a novel agent in this class, in Japanese elderly patients with type 2 diabetes mellitus. MATERIALS AND METHODS: This was a prospective, observational, and multicenter post-marketing study conducted in the context of routine clinical practice...
January 20, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28042352/potentially-inappropriate-prescribing-andthe-risk-of-adverse-drug-reactions-in-critically-ill-older-adults
#4
Thamires B Galli, Wálleri C Reis, Vânia M Andrzejevski
BACKGROUND: Potentially inappropriate medication (PIM) use in the elderly is associated with increased risk of adverse drug reactions (ADRs), but there is limited information regarding PIM use in the intensive care unit (ICU) setting. OBJECTIVE: The aim of the study is to describe the prevalence and factors associated with the use of PIM and the occurrence of PIM-related adverse reactions in the critically ill elderly. METHODS: This study enrolled all critically ill older adults (60 years or more) admitted to medical or cardiovascular ICUs between January and December 2013, in a large tertiary teaching hospital...
October 2016: Pharmacy Practice
https://www.readbyqxmd.com/read/28000156/predicting-the-risk-of-adverse-drug-reactions-in-older-inpatients-external-validation-of-the-gerontonet-adr-risk-score-using-the-crime-cohort
#5
Mirko Petrovic, Balamurugan Tangiisuran, Chakravarthi Rajkumar, Tischa van der Cammen, Graziano Onder
BACKGROUND: Adverse drug reactions (ADRs) in older people are often preventable, indicating that screening and prevention programs aimed at reducing their rate are needed in this population. OBJECTIVE: The aim of this study was to externally validate the GerontoNet ADR risk score and to assess its validity in specific subpopulations of older inpatients. METHODS: Data from the prospective CRIteria to assess appropriate Medication use among Elderly complex patients (CRIME) cohort were used...
December 20, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27990752/risk-for-hip-fracture-due-to-alpha-blocker-treatment-in-korean-women-national-health-insurance-database-study
#6
Gi H Seo, Sung R Shim, Hwan W Lee, Jin H Kim, Dong-Il Chun, Hyun J Kim, Hyun Y Lee, Jae H Kim
OBJECTIVE: The aim of this study is to evaluate the risk for hip fracture associated with adverse drug reactions caused by α1-adrenergic (alpha) blockers to treat female voiding dysfunction. METHODS: Information from the Health Insurance Review and Assessment Service database from January 1, 2008 to December 31, 2012 was used. Hip fracture women patients who received a prescription for an alpha blocker due to voiding dysfunction were the cases. A 30-day hazard period after administration of an alpha blocker was set...
December 19, 2016: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/27913837/hospitalizations-due-to-preventable-adverse-reactions-a-systematic-review
#7
REVIEW
Nidhi S Patel, Tejas K Patel, Parvati B Patel, Viren N Naik, C B Tripathi
PURPOSE: The study aimed to measure the percentage of preventable adverse drug reactions that lead to the hospitalization (PADRAd) and to explore the heterogeneity in its estimation through subgroup analysis of study characteristics. METHODS: Two investigators independently searched in electronic databases and related bibliography for prospective studies involving PADRAd. We excluded studies investigating medication errors and spontaneous and retrospective reporting...
December 2, 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27900534/heart-failure-management-in-the-elderly-a%C3%A2-public-health-challenge
#8
REVIEW
Natasa Cvetinovic, Goran Loncar, Jerneja Farkas
Heart failure (HF) is a rapidly growing public health problem and the leading cause of morbidity, mortality, and hospitalization in populations > 65 years. The elderly HF patients have an increased prevalence of HF with preserved ejection fraction and comorbidities, may present with atypical symptoms and signs, have a higher risk for adverse drug reactions, and worse prognosis as compared with younger patients. Moreover, there is a lack of evidence-based therapies for this population because they are underrepresented in the clinical trials...
December 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27895472/safety-and-effectiveness-of-daily-teriparatide-for-osteoporosis-in-patients-with-severe-stages-of-chronic-kidney-disease-post-hoc-analysis-of-a-postmarketing-observational-study
#9
Atsushi Nishikawa, Fumito Yoshiki, Masanori Taketsuna, Kenta Kajimoto, Hiroyuki Enomoto
Teriparatide (recombinant 1-34 N-terminal sequence of human parathyroid hormone) for the treatment of osteoporosis should be prescribed with caution in patients with severe stages of chronic kidney disease (CKD). However, in clinical settings, physicians and surgeons who treat such patients have few available options. We sought to further explore the safety and effectiveness of teriparatide for the treatment of osteoporosis in Japanese patients with severe stages of CKD. This was a post hoc analysis of a postmarketing surveillance study that included patients with osteoporosis at high risk of fracture and stage 4 or 5 CKD...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27877074/association-between-benzodiazepine-use-and-dementia-data-mining-of-different-medical-databases
#10
Mitsutaka Takada, Mai Fujimoto, Kouichi Hosomi
Purpose: Some studies have suggested that the use of benzodiazepines in the elderly is associated with an increased risk of dementia. However, this association might be due to confounding by indication and reverse causation. To examine the association between benzodiazepine anxiolytic drug use and the risk of dementia, we conducted data mining of a spontaneous reporting database and a large organized database of prescriptions. Methods: Data from the US Food and Drug Administration Adverse Event Reporting System (FAERS) from the first quarter of 2004 through the end of 2013 and data from the Canada Vigilance Adverse Reaction Online Database from the first quarter of 1965 through the end of 2013 were used for the analyses...
2016: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/27875919/adverse-drug-reactions-associated-with-off-label-use-of-ketorolac-with-particular-focus-on-elderly-patients-an-analysis-of-the-italian-pharmacovigilance-database-and-a-population-based-study
#11
E Viola, G Trifirò, Y Ingrasciotta, L Sottosanti, M Tari, F Giorgianni, U Moretti, R Leone
OBJECTIVE: This study aims to evaluate the frequency of off-label use of ketorolac in Italy and the related suspected adverse drug reactions (ADRs) reported. METHODS: All the suspected cases associated with ketorolac recorded in the Italian Pharmacovigilance database were retrieved. Case evaluations were carried out in order to identify the off-label use of ketorolac. Moreover, an analysis of the inappropriate use of ketorolac was conducted using the 'Arianna' database of Caserta local health unit...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27872943/-adverse-drug-reactions-in-elderly-people-first-data-from-the-leipzig-research-center-for-civilization-diseases-life
#12
REVIEW
R Treudler, F Walther, P Ahnert, J-C Simon
BACKGROUND: Few data exist on adverse drug reactions (ADR) in elderly people. In this group, pharmacotherapy represents a challenge with regard to comorbidities, drug interactions and compliance. OBJECTIVE: The aim of this article is to highlight the characteristics of ADR in elderly patients. METHODS: In addition to a literature review we present the first data from the Leipzig Research Center for Civilization Diseases (LIFE). Between 2011 and 2015 a total of 9537 subjects aged 40-79 years were randomly included in this population-based, age and sex standardized investigation in the inhabitants of Leipzig, Germany and special emphasis was placed on allergies including questions with regard to ADR...
November 21, 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/27798708/prediction-of-hospitalization-due-to-adverse-drug-reactions-in-elderly-community-dwelling-patients-the-padr-ec-score
#13
Nibu Parameswaran Nair, Leanne Chalmers, Michael Connolly, Bonnie J Bereznicki, Gregory M Peterson, Colin Curtain, Ronald L Castelino, Luke R Bereznicki
BACKGROUND: Adverse drug reactions (ADRs) are the major cause of medication-related hospital admissions in older patients living in the community. This study aimed to develop and validate a score to predict ADR-related hospitalization in people aged ≥65 years. METHODS: ADR-related hospitalization and its risk factors were determined using a prospective, cross-sectional study in patients aged ≥65 years admitted to two hospitals. A predictive model was developed in the derivation cohort (n = 768) and the model was applied in the validation cohort (n = 240)...
2016: PloS One
https://www.readbyqxmd.com/read/27788886/evaluation-of-long-term-safety-and-efficacy-of-omalizumab-in-elderly-patients-with-uncontrolled-allergic-asthma
#14
Tugba Songul Tat, Aykut Cilli
BACKGROUND: Severe asthma management in elderly patients may be difficult because of increased comorbid conditions, polypharmacy, physiologic changes that occur with aging, incorrect use of inhaler devices, and poor adherence. OBJECTIVE: To evaluate the long-term safety and efficacy of the anti-IgE antibody omalizumab in elderly (aged ≥65 years) patients with uncontrolled allergic asthma. METHODS: The efficiency and adverse effects of omalizumab treatment were evaluated based on data extracted from medical records...
November 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27761112/hospitalizations-due-to-adverse-drug-events-in-the-elderly-a-retrospective-register-study
#15
Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27747829/risk-factors-associated-with-the-requirement-for-pharmaceutical-intervention-in-the-hospital-setting-a-systematic-review-of-the-literature
#16
REVIEW
Emma Suggett, John Marriott
BACKGROUND: A number of methods exist for the risk assessment of hospital inpatients to determine the likelihood of patients experiencing drug-related problems (DRPs), including manual review of a patient's medication (medication reviews) and more complex electronic assessment using decision support alerts in electronic prescribing systems. A systematic review was conducted to determine the evidence base for potential risks associated with adult hospital inpatients that could not only lead to medication-related issues but might also be directly associated with pharmacist intervention...
September 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27734707/-polypharmacy-viewed-not-only-through-the-prism-of-multi-morbidity-but-also-as-an-independent-geriatric-syndrome
#17
Pavel Weber, Hana Meluzínová, Dana Prudius, Katarína Bielaková
Polypharmacy is common in the elderly, especially in the late age (over 75 years). Usually it is closely related to the geriatric multi-morbidity. The authors highlight the medication used in the anticipated positive and potential negative potential. While physicians often must make difficult trade-offs between the guidelines on one hand and complicated multi-morbidity, on the other hand, while trying to avoid polypharmacy ( 5 drugs), especially excessive polypharmacy ( 10 drugs). Multimorbid elderly patients who are treated in accordance with guidelines typically use large amounts of medicaments...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27681233/vancomycin-associated-henoch-sch%C3%A3-nlein-purpura
#18
Zaw Min, Raquel R Garcia, Monika Murillo, Jeffrey M Uchin, Nitin Bhanot
Intravenous vancomycin is a widely used antibiotics, but it causes different types of cutaneous hypersensitivity reactions, ranging from maculopapular rash, red-man syndrome, drug rash with eosinophilia and systemic symptoms, IgA bullous dermatosis, leukocytoclastic vasculitis, Stevens-Johnsons syndrome, to IgE-mediated anaphylaxis. We report an elderly patient with the end-stage renal disease presented with diffuse palpable purpura while receiving IV vancomycin therapy for methicillin-resistant Staphylococcus aureus septicemia...
September 25, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27651709/deprescription-the-prescription-metabolism
#19
REVIEW
Gurusamy Sivagnanam
Deprescribing is a structured approach to drug discontinuation. An alternative suggested term is "prescription metabolism." The major aim of deprescription is to purge the drug(s) considered unwanted in a given patient, especially in the elderly patients with multiple comorbidities or in those suffering from chronic disease. Like drug metabolism, prescription metabolism is a way of eliminating unwanted, troublesome, or cost-ineffective medications. The removal of such drugs has been found to decrease the incidence of adverse drug reactions and improves the rate of medication adherence, thereby reducing the economic burden on the patient as well as on the health care providers...
July 2016: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/27628036/association-between-polypharmacy-and-cognitive-impairment-in-an-elderly-japanese-population-residing-in-an-urban-community
#20
Hirotoshi Niikawa, Tsuyoshi Okamura, Kae Ito, Chiaki Ura, Fumiko Miyamae, Naoko Sakuma, Mutsuo Ijuin, Hiroki Inagaki, Mika Sugiyama, Shuichi Awata
AIM: Polypharmacy is a serious medical problem among older adults. Polypharmacy can cause adverse drug reactions and is associated with frailty. Several drugs, particularly psychotropic medications, can cause cognitive impairment. Recent research also suggests that polypharmacy can cause cognitive impairment. We investigated the prevalence of polypharmacy, and examined the association between polypharmacy and cognitive impairment in a large sample of community-dwelling older adults in Japan...
September 15, 2016: Geriatrics & Gerontology International
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