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Adverse drug reactions in the elderly

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
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
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
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
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
Hiroyuki Ito, Masahiro Shinozaki, Shinya Nishio, Mariko Abe
INTRODUCTION: Sodium glucose cotransporter 2 (SGLT2) inhibitors have been available for the treatment of type 2 diabetes (T2DM) in Japan since April 2014. The prescription rate in Japan is low in comparison to Western countries. We summarize the results obtained from the phase 3 clinical trials and clinical studies involving Japanese T2DM patients. We also discuss the current situation and the future prospects of SGLT2 inhibitors in Japan. AREAS COVERED: Unexpected adverse events, such as cerebral infarction and diabetic ketoacidosis have been reported from clinics shortly after the initiation of SGLT2 inhibitor treatment...
October 2016: Expert Opinion on Pharmacotherapy
Fantaye Teka, Gebrehiwot Teklay, Eskindeir Ayalew, Terefe Teshome
BACKGROUND: The elderly are considered as special population, as they differ from younger adults in terms of comorbidity, polypharmacy, pharmacokinetics, vulnerability to drug-drug interactions and adverse drug reactions. Despite the fact that the elderly patients are at high risk of having drug interaction and potential adverse outcomes, studies in this regard are scarce in resource limited settings like Ethiopia. The aim of this study was to assess the prevalence and determinants of potential drug-drug interaction in elderly patients admitted to medical ward of Ayder Referral Hospital in Northern Ethiopia...
2016: BMC Research Notes
Luca Pasina, Sarah Astuto, Laura Cortesi, Mauro Tettamanti, Carlotta Franchi, Alessandra Marengoni, Pier Mannuccio Mannucci, Alessandro Nobili
BACKGROUND: Explicit criteria for potentially inappropriate prescriptions in the elderly are recommended to avoid prescriptions of duplicate drug classes and to optimize monotherapy within a single drug class before a new agent is considered. Duplicate drug class prescription (or therapeutic duplicates) puts the patient at increased risk of adverse drug reactions with no additional therapeutic benefits. To our knowledge, the prevalence of elderly inpatients receiving therapeutic duplicates has never been studied...
September 2016: Drugs & Aging
K Gazzola, G B Vigna
AIMS: Cardiovascular disease is a major cause of death worldwide. Safety and efficacy of lipid lowering therapy have been clearly established for either primary and secondary prevention of cardiovascular events in adults. Nevertheless, the use of hypolipidemic drugs in elderly individuals, especially in the oldest ones, still raises some concerns. Aim of this paper is to review indications and limits of lipid lowering in advanced age, furnishing a practical medical attitude tempered by clinical and geriatric competences...
July 21, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Koutaro Yokote, Yasuo Terauchi, Ichiro Nakamura, Haruko Sugamori
OBJECTIVE: To investigate the real-world safety of ipragliflozin in elderly Japanese patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: Japanese patients (≥65 years old) who were first prescribed ipragliflozin within 3 months after its launch in April 2014 were registered in this post-marketing surveillance (PMS). Final data collection was in July 2015. Survey items included demographics, treatments, adverse drug reactions (ADRs), vital signs, and laboratory variables...
October 2016: Expert Opinion on Pharmacotherapy
Mulugeta Tarekegn Angamo, Leanne Chalmers, Colin M Curtain, Luke R E Bereznicki
Adverse drug reactions (ADRs) are one of the leading causes of hospital admissions and morbidity in developed countries and represent a substantial burden on healthcare delivery systems. However, there is little data available from low- and middle-income countries. This review compares the prevalence and characteristics of ADR-related hospitalisations in adults in developed and developing countries, including the mortality, severity and preventability associated with these events, commonly implicated drugs and contributing factors...
September 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Shobita Rajagopalan
Tuberculosis (TB) remains one of the world's most lethal infectious diseases. Preventive and control strategies among other high-risk groups, such as the elderly population, continues to be a challenge. Clinical features of TB in older adults may be atypical and confused with age-related diseases. Diagnosis and management of TB in the elderly person can be difficult; treatment can be associated with adverse drug reactions. This article reviews the current global epidemiology, pathogenesis, clinical characteristics, diagnosis, management, and prevention of Mycobacterium tuberculosis infection in community-dwelling and institutionalized aging adults...
August 2016: Clinics in Geriatric Medicine
Lukshe Kanagaratnam, Malak Abou Taam, Marie Heng, Paul De Boissieu, Marie-Paule Roux, Thierry Trenque
AIM: To describe the serious adverse drug reactions (ADR) in elderly subjects aged over 65 years and assess their preventability. METHODS: A retrospective study was conducted at the Regional Pharmacovigilance Center of Champagne-Ardenne (northeast of France) between January and May 2013. Patients aged over 65 years who presented a serious ADR notified to the Regional Pharmacovigilance Center were included in the study. RESULTS: Over the study period, 100 subjects were included in the study...
September 2015: Thérapie
Amanda H Lavan, Paul F Gallagher, Denis O'Mahony
The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers' lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission...
2016: Clinical Interventions in Aging
Da Woon Sim, Kyung Hee Park, Hye Jung Park, Young Woong Son, Sang Chul Lee, Jung-Won Park, Jae-Hyun Lee
PURPOSE: The use of monoclonal antibodies (mAbs) is increasing in various clinical fields. Although mAb safety must be demonstrated prior to approval, targeted pharmacovigilance is essential for the recognition and assessment of adverse reactions. The purpose of this study was to identify the major clinical features of adverse reactions to mAbs in Korea. METHODS: Spontaneous reports of adverse reactions attributed to 18 mAbs from January 2005 to December 2014 were extracted from the Korea Adverse Event Reporting System...
June 30, 2016: Pharmacoepidemiology and Drug Safety
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) Med Watch program (800-FDA-1088). If you have reported an interesting, preventable ADR to Med Watch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: Your report will be published anonymously unless otherwise requested...
June 2016: Hospital Pharmacy
Thamir M Alshammari
BACKGROUND: Drug safety is one of the hottest topics in daily medical practice, particularly with regard to approving new medication or questioning the possibility of withdrawing a drug from the market. AIM: The aim of this review is to highlight the importance of the drug safety concept and its impact on patients' health. METHODS: A literature search was conducted using Pubmed®, EMBASE®, EBSCO and Medline in the period between 1980 and 2013...
July 2016: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Shanshan Ding, Fei Long, Shujuan Jiang
Erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor, is an oral targeted anticancer drug that is used to treat non-small cell lung cancer (NSCLC). Previous studies have confirmed that erlotinib is safe and is well-tolerated by patients. The most common adverse reactions observed following erlotinib treatment include a rash and mild diarrhea. In the current study, the first case of acute myocardial infarction following one month of treatment with erlotinib in a 63-year-old male NSCLC patient is presented...
June 2016: Oncology Letters
Efraim Aizen, Eman Hindawil, Mohammed Hijazi, Atef Merih, Hatim Shahla, Ahmad Abu Elyounes
INTRODUCTION: Polypharmacy, inappropriate prescribing and adverse drug reactions are frequent and important among elderly nursing home residents. Few clinical trials have evaluated systematic withdrawal of medications in nursing homes. OBJECTIVES: To compare the effect of a controlled deprescribing intervention against the usual care in elderly nursing home residents. METHODS: The present deprescribing intervention was conducted in two departments at the Shfaram Geriatric Center (Beet Alenaya)...
March 2016: Harefuah
Nina M Bemben
Polypharmacy has been found to have potentially negative consequences for patients due to use of potentially inappropriate medications, as well as increased risk of drug interactions and adverse effects. Deprescribing has been proposed as a method of improving medication use throughout a patient's course of care. This article reviews the process of deprescribing and applies the process to medication classes commonly encountered by clinical pharmacists. This review of therapeutics included studies identified through a PubMed search and by review of the reference list of included studies...
July 2016: Pharmacotherapy
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