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Drug interactions in the elderly

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https://www.readbyqxmd.com/read/28805310/use-of-direct-oral-anticoagulants-for-stroke-prevention-in-elderly-patients-with-nonvalvular-atrial-fibrillation
#1
Lynn B Oertel, Annemarie E Fogerty
BACKGROUND AND PURPOSE: Four direct oral anticoagulants (DOACs) are available for the prevention of stroke in nonvalvular atrial fibrillation (NVAF): dabigatran (a direct thrombin inhibitor); and rivaroxaban, apixaban, and edoxaban (factor Xa inhibitors). This article summarizes the safety and efficacy of DOACs for the prevention of stroke in elderly NVAF patients. METHODS: PubMed was searched to identify published results of randomized, controlled trials evaluating DOACs for stroke prevention in elderly NVAF patients...
August 14, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28799126/hydration-status-drug-interactions-and-determinants-in-a-spanish-elderly-population-a-pilot-study
#2
A M Puga, T Partearroyo, G Varela-Moreiras
Proper hydration is essential to maintain optimal health and well-being at all stages of life, especially for the elderly. Side effects of certain drugs that affect hydration status may compromise the health of the ancients, who also constitute the most vulnerable group. No studies have been carried out, to our knowledge, at the intersection of drugs and hydration status. Our study aimed to evaluate the effects of chronic use of certain drugs (diuretics, corticoids and metformin) in the hydration status of the elderly...
August 10, 2017: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/28776468/falls-the-adverse-drug-reaction-of-the-elderly-and-the-impact-of-pharmacogenetics
#3
Katja Susanne Just, Katharina Luise Schneider, Marlen Schurig, Julia Carolin Stingl, Jürgen Brockmöller
Falls is a frequent type of adverse drug reactions causing significant morbidity and mortality in the elderly. We reviewed, with which drugs the risk of falls is relevant and might depend on genomic variation. Pharmacogenetic variability may contribute to drug-induced falls for instance mediated by impaired drug elimination due to inherited deficiency in enzymes like CYP2C9, CYP2C19 and CYP2D6. The relative role of specific genes and polymorphisms in old age may differ from younger people. Biomarkers for frailty, but also genomic biomarkers might help identifying patients at high risk for drug-induced falls...
August 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28757769/the-borderland-between-normal-aging-and-dementia
#4
REVIEW
Raymond Y Lo
Alzheimer's disease (AD) has become a global health issue as the population ages. There is no effective treatment to protect against its occurrence or progression. Some argue that the lack of treatment response is due to delays in diagnosis. By the time a diagnosis of AD is made, neurodegenerative changes are at the stage where very few neurons can be salvaged by medication. The AD research community has developed the idea of mild cognitive impairment (MCI) in an attempt to find predementia patients who might benefit from potentially therapeutic drugs that have proven ineffective in the past...
April 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28751847/anmco-position-paper-the-use-of-non-vitamin-k-dependent-new-oral-anticoagulant-s-in-pulmonary-embolism-therapy-and-prevention
#5
Iolanda Enea, Loris Roncon, Michele Massimo Gulizia, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Franco Casazza, Claudio Cuccia, Carlo D'Agostino, Matteo Rugolotto, Marco Vatrano, Eugenio Vinci, Paride Fenaroli, Dario Formigli, Paolo Silvestri, Federico Nardi, Maria Cristina Vedovati, Marino Scherillo
The new oral anticoagulants (NOACs) have radically changed the approach to the treatment and prevention of thromboembolic pulmonary embolism. The authors of this position paper face, in succession, issues concerning NOACs, including (i) their mechanism of action, pharmacodynamics, and pharmacokinetics; (ii) the use in the acute phase with the 'double drug single dose' approach or with 'single drug double dose'; (iii) the use in the extended phase with demonstrated efficacy and with low incidence of bleeding events; (iv) the encouraging use of NOACs in particular subgroups of patients such as those with cancer, the ones under- or overweight, with renal insufficiency (creatinine clearance > 30 mL/min), the elderly (>75 years); (v) they propose a possible laboratory clinical pathway for follow-up; and (vi) carry out an examination on the main drug interactions, their potential bleeding risk, and the way to deal with some bleeding complications...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28748481/public-health-relevance-of-drug-nutrition-interactions
#6
Szabolcs Péter, Gerjan Navis, Martin H de Borst, Clemens von Schacky, Anne Claire B van Orten-Luiten, Alexandra Zhernakova, Renger F Witkamp, André Janse, Peter Weber, Stephan J L Bakker, Manfred Eggersdorfer
The public health relevance of drug-nutrition interactions is currently highly undervalued and overlooked. This is particularly the case for elderly persons where multi-morbidity and consequently polypharmacy is very common. Vitamins and other micronutrients have central functions in metabolism, and their interactions with drugs may result in clinically relevant physiological impairments but possibly also in positive effects. On 12 April 2016, the University Medical Center Groningen (The Netherlands), as part of its Healthy Ageing program, organized a workshop on the public health relevance of drug-nutrient interactions...
July 26, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/28716467/clinically-relevant-potential-drug-drug-interactions-among-outpatients-a-nationwide-database-study
#7
Janja Jazbar, Igor Locatelli, Nejc Horvat, Mitja Kos
BACKGROUND: Adverse drug events due to drug-drug interactions (DDIs) represent a considerable public health burden, also in Slovenia. A better understanding of the most frequently occurring potential DDIs may enable safer pharmacotherapy and minimize drug-related problems. OBJECTIVES: The aim of this study was to evaluate the prevalence and predictors of potential DDIs among outpatients in Slovenia. METHODS: An analysis of potential DDIs was performed using health claims data on prescription drugs from a nationwide database...
July 11, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28707259/rhabdomyolysis-and-aki-with-atorvastatin-and-sitagliptin-use-in-the-setting-of-low-25-hydroxyvitamin-d-levels
#8
Rupinder Singh Buttar, Jasveen Batra, Jacqueline Kreimerman, Melissa Aleta, Michal L Melamed
We report a case of an 86-year-old woman admitted to the hospital with rhabdomyolysis and acute kidney injury 3 weeks after starting sitagliptin while on long-term atorvastatin therapy. She also had low levels of 25-hydroxyvitamin D and mild chronic kidney disease, which may have contributed to the development of rhabdomyolysis. A review of the literature reveals four previous reports of this drug interaction in elderly patients, some with underlying kidney disease.
July 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28688072/-a%C3%A2-qualitative-exploration-of-the-chronic-use-of-psychotropic-drugs-in-nursing-homes
#9
Lukas Leten, Majda Azermai, Maarten Wauters, Jan De Lepeleire
BACKGROUND: Although guidelines put forward non-pharmacological therapies and advise against the chronic use of psychotropic drugs, these are still being prescribed regularly in Belgian nursing homes. GOAL: To explore the reasons for initiation, continuation and cessation of psychotropic drug treatment of elderly with dementia and behavioral problems, residing in the nursing home. METHOD: Twenty-seven interviews from an earlier project were used, in which a semi-structured interview was conducted with the nursing staff, the physicians and the caretakers of eleven randomly selected residents from three nursing homes...
July 7, 2017: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/28665037/prevalence-of-potentially-serious-drug-drug-interactions-among-south-african-elderly-private-health-sector-patients-using-the-mimica-matanovi%C3%A4-vlahovi%C3%A4-pal%C3%A4-evski-protocol
#10
Julandi A van Heerden, Johanita R Burger, Jan J Gerber, Vera Vlahović-Palčevski
OBJECTIVES: To determine the prevalence of potentially serious drug-drug interactions (DDIs) and their relationship with gender and age, among elderly in South Africa. METHODS: A cross-sectional study was conducted using pharmaceutical claims data for 2013, for a total of 103 420 medical scheme beneficiaries' ≥65 years. All medications dispensed within one calendar month where the days' supply of medication dispensed overlapped, were grouped as one prescription...
June 30, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28663671/efficacy-and-safety-of-sofosbuvir-based-direct-acting-antivirals-for-hepatitis-c-in-septuagenarians-and-octogenarians
#11
Heather S Snyder, Bilal Ali, Humberto C Gonzalez, Satheesh Nair, Sanjaya K Satapathy
BACKGROUND/AIMS: Treatment of chronic hepatitis C (HCV) with newer direct acting antiviral (DAA) agents has been highly effective. Unfortunately, patients over 70 years old are underrepresented in studies. Given current recommendations to screen patients born between 1945 and 1965 for HCV, it is essential to determine the efficacy and safety of DAAs within the elderly population. This study aims to evaluate clinical outcomes of patients aged 70 years or older treated for HCV with DAAs at a single tertiary care center...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28656517/treatment-of-hyperkalemia-in-heart-failure
#12
REVIEW
Ersilia M DeFilippis, Akshay S Desai
PURPOSE OF REVIEW: The aim of this paper is to discuss strategies for prevention and management of hyperkalemia in patients with heart failure, including the role of novel therapies. RECENT FINDINGS: Renin-angiotensin-aldosterone system (RAAS) antagonists, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA) decrease mortality and morbidity in heart failure but increase the risk of hyperkalemia, especially when used in combination...
August 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28654954/bioequivalence-between-generic-and-branded-lamotrigine-in-people-with-epilepsy-the-equigen-randomized-clinical-trial
#13
Michel Berg, Timothy E Welty, Barry E Gidal, Francisco J Diaz, Ron Krebill, Jerzy P Szaflarski, Barbara A Dworetzky, John R Pollard, Edmund J Elder, Wenlei Jiang, Xiaohui Jiang, Regina D Switzer, Michael D Privitera
Importance: Switching between generic antiepileptic drugs is a highly debated issue that affects both clinical care and overall health care costs. Objective: To evaluate the single-dose pharmacokinetic bioequivalence of 3 (1 branded and 2 generic drugs) on-market, immediate-release lamotrigine drug products. Design, Setting, and Participants: The Equivalence Among Antiepileptic Drug Generic and Brand Products in People With Epilepsy (EQUIGEN) single-dose study is a crossover, prospective, sequence-randomized, replicate pharmacokinetic study conducted at 5 US academic epilepsy centers...
August 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28652716/can-we-improve-pain-and-sleep-in-elderly-individuals-with-transcranial-direct-current-stimulation-results-from-a-randomized-controlled-pilot-study
#14
Marie-Philippe Harvey, Dominique Lorrain, Marylie Martel, Kayla Bergeron-Vezina, Francis Houde, Mario Séguin, Guillaume Léonard
BACKGROUND: The prevalence of chronic pain and sleep disturbances substantially increases with age. Pharmacotherapy remains the primary treatment option for these health issues. However, side effects and drug interactions are difficult to control in elderly individuals. AIMS: The objective of this study was to assess the feasibility of conducting a randomized sham-controlled trial and to collect preliminary data on the efficacy of transcranial direct current stimulation (tDCS) to reduce pain and improve sleep in older adults suffering from chronic pain...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28651903/the-elderly-and-direct-antiviral-agents-constraint-or-challenge
#15
Claudia Fabrizio, Annalisa Saracino, Luigia Scudeller, Eugenio Milano, Raffaele Dell'Acqua, Giuseppe Bruno, Sergio Lo Caputo, Laura Monno, Michele Milella, Gioacchino Angarano
BACKGROUND: Direct antiviral agents (DAAs) for chronic hepatitis C showed great effectiveness and good safety profile. So far, few data are available about their use in elderly subjects. AIM: To assess management, safety and outcome of DAAs treatments in the elderly. METHODS: This retrospective, single-centre study enrolled all patients aged ≥65 years, compared by age (group A: 65-74 years, group B: ≥75 years), who completed DAAs between February 2015-November 2016...
June 1, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28650400/high-need-to-switch-cart-or-co-medication-with-the-initiation-of-daas-in-elderly-hiv-hcv-co-infected-patients
#16
Elise J Smolders, Colette Smit, Clara Tmm De Kanter, Anton Dofferhoff, Joop E Arends, Kees Brinkman, Bart Rijnders, Marc Van Der Valk, Peter Reiss, David M Burger
BACKGROUD: To describe the use of non-antiretroviral co-medication and combination antiretroviral therapy (cART) in HIV/hepatitis C virus (HCV) co-infected patients, and to predict the potential for drug-drug interactions (DDIs) with direct-acting antivirals (DAAs) against HCV. METHODS: This is a retrospective, cross-sectional study, using the Dutch nationwide ATHENA observational HIV cohort database. All patients with a known HIV/HCV co-infection on 1 January 2015 were included...
June 22, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28623363/machine-learning-workflow-to-enhance-predictions-of-adverse-drug-reactions-adrs-through-drug-gene-interactions-application-to-drugs-for-cutaneous-diseases
#17
Kalpana Raja, Matthew Patrick, James T Elder, Lam C Tsoi
Adverse drug reactions (ADRs) pose critical public health issues, affecting over 6% of hospitalized patients. While knowledge of potential drug-drug interactions (DDI) is necessary to prevent ADR, the rapid pace of drug discovery makes it challenging to maintain a strong insight into DDIs. In this study, we present a novel literature-mining framework for enhancing the predictions of DDIs and ADR types by integrating drug-gene interactions (DGIs). The ADR types were adapted from a DDI corpus, including i) adverse effect; ii) effect at molecular level; iii) effect related to pharmacokinetics; and iv) DDIs without known ADRs...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28622547/co-morbidity-and-clinically-significant-interactions-between-antiepileptic-drugs-and-other-drugs-in-elderly-patients-with-newly-diagnosed-epilepsy
#18
Emmi Bruun, Lauri J Virta, Reetta Kälviäinen, Tapani Keränen
PURPOSE: A study was conducted to investigate the frequency of potential pharmacokinetic drug-to-drug interactions in elderly patients with newly diagnosed epilepsy. We also investigated co-morbid conditions associated with epilepsy. METHOD: From the register of Kuopio University Hospital (KUH) we identified community-dwelling patients aged 65 or above with newly diagnosed epilepsy and in whom use of the first individual antiepileptic drug (AED) began in 2000-2013 (n=529)...
June 13, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28595684/marijuana-use-in-the-elderly-implications-and-considerations
#19
Tracy D Mahvan, Michelle L Hilaire, Allison Mann, Antoinette Brown, Becky Linn, Taylor Gardner, Beryen Lai
OBJECTIVE: This article reviews the literature on the use of marijuana in the elderly. Pharmacists play an important role in the management of medications including drug use of potentially illegal drugs, including marijuana. The use of both recreational and medical marijuana has grown exponentially in the general population, including in older adults. As of 2017, marijuana for medical use is legal in 26 states and the District of Columbia. DATA SOURCES: PubMed and Internet search using the following terms: marijuana, cannabis, delta-9-tetrhydrocannabinol (THC), cannabidiol, cannabinoid, elderly, geriatric, and pharmacology...
June 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28575767/lacosamide-and-concomitant-use-of-antiepileptic-and-other-medications-in-a-us-population-a-retrospective-cohort-study
#20
Linda Kalilani, Chao Lu, Bosny Pierre-Louis, Michael Gold
Information on the use of lacosamide and concomitant antiepileptic and non-antiepileptic drugs (non-AEDs) is available from clinical trials and observational studies with small sample sizes. This retrospective cohort study was conducted to gain insight into the use of lacosamide in a large number of patients with epilepsy in real-life clinical practice with less restrictive selection criteria compared with clinical trial participants. The Truven Health MarketScan (Commercial Claims and Medicare Supplemental) database was used to identify patients with a prior diagnosis of epilepsy with at least one prescription claim for lacosamide between June 2009 and September 2013 and continuous health insurance enrolment with medical and pharmacy coverage during the 1-year pre-index baseline period...
May 30, 2017: Epilepsy & Behavior: E&B
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