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Drug interactions in the elderly

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https://www.readbyqxmd.com/read/28211099/sedation-with-orally-administered-midazolam-in-elderly-dental-patients-with-major-neurocognitive-disorder
#1
Lena Rignell, Mona Mikati, Madeleine Wertsén, Catharina Hägglin
OBJECTIVE: The aim of this study was to evaluate acceptance of treatment after oral sedation with midazolam in dental patients with major neurocognitive disorder. BACKGROUND: Midazolam is commonly used as premedication in paediatric dentistry, oral surgery and people suffering from dental fear. Little is known about its use in other patient groups. METHODS: Dental and sedation records of 61 patients (64% women) sedated with midazolam were examined retrospectively...
February 17, 2017: Gerodontology
https://www.readbyqxmd.com/read/28191610/italian-intersociety-consensus-on-doac-use-in-internal-medicine
#2
Domenico Prisco, Walter Ageno, Cecilia Becattini, Armando D'Angelo, Giovanni Davì, Raimondo De Cristofaro, Francesco Dentali, Giovanni Di Minno, Anna Falanga, Gualberto Gussoni, Luca Masotti, Gualtiero Palareti, Pasquale Pignatelli, Roberto M Santi, Francesca Santilli, Mauro Silingardi, Antonella Tufano, Francesco Violi
The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events...
February 13, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#3
REVIEW
Joanne M Foody
Non-valvular atrial fibrillation (NVAF) significantly contributes to the burden of stroke, particularly in elderly patients. The challenge of optimizing anticoagulation therapy is balancing efficacy and bleeding risk, especially as the same patients at high risk of stroke also tend to be at high risk of bleeding. Treating the elderly patient with NVAF presents special challenges because of their heightened risk for both stroke and bleeding. Despite clinical trial data and evidence-based guidelines, surveys indicate that physicians underuse anticoagulation in older patients for reasons that include overemphasis of bleeding risk, particularly with the increased risk of falling, at the cost of thromboembolic risk...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28177748/possible-association-between-helicobacter-pylori-infection-and-non-alcoholic-fatty-liver-disease
#4
Chang-Xi Chen, Yu-Shan Mao, Parker Foster, Zhong-Wei Zhu, Juan Du, Chuan-Yong Guo
Possible association between Helicobacter pylori infection (HPI) and nonalcoholic fatty liver disease (NAFLD) has been proposed by several studies with inconsistent conclusions. Here, we studied the association between HPI and NAFLD at three levels: 1.) Genetic level; 2.) Small molecular level; and 3.) Clinical level. Relation data between diseases, genes, and small molecules were acquired from Pathway Studio ResNet Mammalian database. Clinical data were acquired from 2,263 elderly South Chinese subjects, including 603 NAFLD patients and 1660 non-NAFLD subjects...
November 18, 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/28168532/high-calcium-magnesium-ratio-in-hair-is-associated-with-coronary-artery-calcification-in-middle-aged-and-elderly-individuals
#5
Byoungjin Park, Mi-Hyun Kim, Choong Keun Cha, Yong-Jae Lee, Kyong-Chol Kim
The interaction between calcium and magnesium as a risk modifier for cardiovascular disease (CVD) has been largely overlooked in previous studies, for the strict regulatory system in blood has been thought to keep such homeostatic interactions under tight control. This study aimed to investigate the association between calcium-magnesium ratio in hair and subclinical coronary artery calcification. Using multiple linear regression analysis, we examined the associations between calcium-magnesium ratio in hair and the coronary calcium score (CCS) in 216 Koreans aged 40 years and above (122 men and 94 women)...
February 6, 2017: Biological Trace Element Research
https://www.readbyqxmd.com/read/28133890/characterization-of-new-users-of-cilostazol-in-the-uk-spain-sweden-and-germany
#6
Jordi Castellsague, Susana Perez-Gutthann, Brian Calingaert, Christine Bui, Cristina Varas-Lorenzo, Alejandro Arana, Alexandra Prados-Torres, Beatriz Poblador-Plou, Francisca Gonzalez-Rubio, Maria Giner-Soriano, Albert Roso-Llorach, Marie Linder, Anna Citarella, Oliver Scholle, Tilo Blenk, Edeltraut Garbe
PURPOSE: To describe the characteristics of new users of cilostazol in Europe with the aim to support the evaluation of its benefit/risk as used in regular clinical practice before the implementation of labeling changes recommended by the European Medicines Agency. METHODS: New users of cilostazol were identified in populations enrolled in five European health automated databases in the UK (The Health Improvement Network [THIN]), Spain (EpiChron cohort and Information System for the Improvement of Research in Primary Care [SIDIAP]), Sweden (National Registers), and Germany (German Pharmacoepidemiological Research Database [GePaRD]) between 2002 and 2012...
January 30, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28129493/antipsychotic-drug-interactions-and-mortality-among-nursing-home-residents-with-cognitive-impairment
#7
Rosa Liperoti, Federica Sganga, Francesco Landi, Eva Topinkova, Michael D Denkinger, Henriëtte G van der Roest, Andrea D Foebel, Harriet Finne-Soveri, Roberto Bernabei, Graziano Onder
OBJECTIVE: Among elderly individuals with dementia, the use of antipsychotics has been associated with serious adverse events including ischemic stroke and death. Multiple medications can interact with antipsychotics and increase the risk of such adverse events. The purpose of this retrospective, longitudinal cohort study was to estimate the prevalence of potential antipsychotic drug interactions and their effect on increasing the risk of death among cognitively impaired elderly individuals treated with antipsychotics...
January 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28128811/-herpes-zoster-and-post-herpetic-neuralgia-in-the-elderly-particularities-in-prevention-diagnosis-and-treatment
#8
Ana Isabel García-González, Oscar Rosas-Carrasco
Herpes zoster (HZ) results from the reactivation of the varicella zoster virus latent in the sensory ganglia when cell-mediated immunity is altered. It is a frequent condition in older adults, leading to undesirable adverse outcomes. Aging is its main risk factor and the elderly may have different clinical presentations: zoster sine herpete, and a higher incidence of post-herpetic neuralgia (15%) and ophthalmic herpes (7%). Both HZ and post-herpetic neuralgia may impact the quality of life, functional status, mental health, and social interaction in older adults...
January 2017: Gaceta Médica de México
https://www.readbyqxmd.com/read/28101146/bone-health-in-hiv-and-hepatitis-b-or-c-infections
#9
REVIEW
Emmanuel Biver, Alexandra Calmy, René Rizzoli
Chronic infections with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) add to age-dependent bone loss and may contribute to lower bone strength in the elderly. In this review, we report recent highlights on the epidemiology of bone fragility in chronic viral infections with HIV, HCV and HBV, its physiopathology and discuss the interference of antiviral therapies with bone metabolism. Chronic infections influence bone through the interactions between risk factors for bone fragility and falls (which are highly prevalent in infected patients), virus activity and antiviral drugs...
January 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28095900/post-stroke-dementia-a-comprehensive-review
#10
REVIEW
Milija D Mijajlović, Aleksandra Pavlović, Michael Brainin, Wolf-Dieter Heiss, Terence J Quinn, Hege B Ihle-Hansen, Dirk M Hermann, Einor Ben Assayag, Edo Richard, Alexander Thiel, Efrat Kliper, Yong-Il Shin, Yun-Hee Kim, SeongHye Choi, San Jung, Yeong-Bae Lee, Osman Sinanović, Deborah A Levine, Ilana Schlesinger, Gillian Mead, Vuk Milošević, Didier Leys, Guri Hagberg, Marie Helene Ursin, Yvonne Teuschl, Semyon Prokopenko, Elena Mozheyko, Anna Bezdenezhnykh, Karl Matz, Vuk Aleksić, DafinFior Muresanu, Amos D Korczyn, Natan M Bornstein
Post-stroke dementia (PSD) or post-stroke cognitive impairment (PSCI) may affect up to one third of stroke survivors. Various definitions of PSCI and PSD have been described. We propose PSD as a label for any dementia following stroke in temporal relation. Various tools are available to screen and assess cognition, with few PSD-specific instruments. Choice will depend on purpose of assessment, with differing instruments needed for brief screening (e.g., Montreal Cognitive Assessment) or diagnostic formulation (e...
January 18, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28078647/sitagliptin-a-review-in-type-2-diabetes
#11
Lesley J Scott
The dipeptidyl peptidase-4 inhibitor sitagliptin (Januvia(®); Glactiv(®); Tesavel(®); Xelevia™) is approved in more than 130 countries worldwide as monotherapy and in combination with other antihyperglycaemic drugs for the treatment of adult patients with type 2 diabetes (T2D). Extensive clinical experience has firmly established the glycaemic efficacy of oral sitagliptin (±other antihyperglycaemic drugs) in a broad spectrum of patients with T2D, including obese, elderly and renally impaired patients and those with established cardiovascular (CV) disease (CVD)...
January 11, 2017: Drugs
https://www.readbyqxmd.com/read/28070847/role-of-water-sorption-in-tablet-crushing-strength-disintegration-and-dissolution
#12
M Sacchetti, R Teerakapibal, K Kim, E J Elder
Drugs formulated as tablets are subjected to accelerated stability conditions with the goal of identifying a stable formulation that will exhibit a sufficiently long shelf life. Water sorption at a condition such as 40°C/75% RH can result in significant changes in tablet properties such as a decrease in dissolution rate, the cause of which may be difficult to interpret, given the complex nature of ingredients and their interactions in a tablet. In this research, three drugs, displaying a wide range of physicochemical properties, were formulated with commonly used diluents, disintegrants, and binders, using a design of experiments approach...
January 9, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28069789/hypotension-induced-by-the-concomitant-use-of-a-calcium-channel-blocker-and-clarithromycin
#13
Sayako Takeuchi, Yuki Kotani, Toshihide Tsujimoto
In the elderly, calcium-channel blockers are the first-line treatment for hypertension, and macrolides are commonly prescribed antibiotics. Here we report a 78-year-old man taking nifedipine, diltiazem and carvedilol who presented with persistent hypotension and bradycardia after clarithromycin was prescribed. He was diagnosed with drug-induced hypotension and treated with fluid resuscitation and vasoactive agents. His symptoms gradually improved. He was transferred out of the intensive care unit 3 days after hospitalisation...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28056068/the-association-between-polypharmacy-and-dementia-a-nested-case-control-study-based-on-a-12-year-longitudinal-cohort-database-in-south-korea
#14
Hae-Young Park, Ji-Won Park, Hong Ji Song, Hyun Soon Sohn, Jin-Won Kwon
Dementia is a major concern among growing chronic diseases in the aging society and its association with polypharmacy has not been adequately assessed. The objective of this study was to determine the association between polypharmacy and dementia through multiple statistical approaches. We conducted a nested case-control study for newly diagnosed dementia cases using the South Korean National Health Insurance Service sample cohort database (2002-2013, n = 1,025,340). Interactions between polypharmacy (an average use of ≥5 prescription drugs daily) and comorbidities or potentially inappropriate medications (PIMs) were tested...
2017: PloS One
https://www.readbyqxmd.com/read/28053591/potentially-inappropriate-medications-prescribed-for-elderly-patients-through-family-physicians
#15
Abdulaziz Al Odhayani, Ayla Tourkmani, Mohammed Alshehri, Hala Alqahtani, Adel Mishriky
The elderly population is increasing throughout the globe, resulting in higher healthcare costs. Potential inappropriate medication (PIM) prescriptions are a major health problem affecting the elderly persons. Due to limited studies in PIM use in primary care and home healthcare in Saudi Arabia, we aim to examine the extent of PIM prescription for and use by elderly patients. This study was carried out with 798 elderly patients, arbitrarily selected from Prince Sultan Medical Military City through the patient register...
January 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/28028258/-exploration-of-the-factors-influencing-multi-drug-cancer-chemotherapy-in-the-elderly-a-retrospective-study
#16
Kentaro Ogata, Kazuo Tamura, Fumiaki Kiyomi, Yasushi Takamatsu, Hidetoshi Kamimura
Multi-drug administration is problematic in elderly patients, and the situation is further complicated in those with cancer, owing to a high possibility of side effects and augmentation due to interactions between concomitant or previous drugs the patients are receiving and the anti-cancer drugs administered. Analysis of the factors that influence the likelihood of cancer chemotherapy multi-drug administration in the elderly showed that age alone was a fundamental risk factor for multi-drug administration, comorbidities, and drug interactions...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28000151/the-impact-of-provider-networks-on-the-co-prescriptions-of-interacting-drugs-a-claims-based-analysis
#17
Mei-Sing Ong, Karen L Olson, Laura Chadwick, Chunfu Liu, Kenneth D Mandl
INTRODUCTION: Multiple provider prescribing of interacting drugs is a preventable cause of morbidity and mortality, and fragmented care is a major contributing factor. We applied social network analysis to examine the impact of provider patient-sharing networks on the risk of multiple provider prescribing of interacting drugs. METHODS: We performed a retrospective analysis of commercial healthcare claims (years 2008-2011), including all non-elderly adult beneficiaries (n = 88,494) and their constellation of care providers...
December 20, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/27997328/pathological-jealousy-an-interactive-condition
#18
Mary V Seeman
OBJECTIVE: The aim of this review is to describe the psychopathology, antecedents, and current management of pathological jealousy from an interpersonal perspective. METHOD: The Google Scholar database was searched with the following terms: delusional jealousy; morbid jealousy; paranoid jealousy; pathological jealousy; Othello syndrome; delusional disorder-jealous type; conjugal paranoia. From a total of 600 articles, 40 were selected based on their currency and pertinence to the interpersonal aspects of jealousy...
2016: Psychiatry
https://www.readbyqxmd.com/read/27988986/efficacy-and-safety-of-tadalafil-5mg-once-daily-in-the-treatment-of-lower-urinary-tract-symptoms-associated-with-benign-prostatic-hyperplasia-luts-bph-in-men-aged-75-years-or-older-integrated-analyses-of-pooled-data-from-multinational-randomised-placebo-controlled
#19
Matthias Oelke, Adrian Wagg, Yasushi Takita, Hartwig Büttner, Lars Viktrup
OBJECTIVE: To assess efficacy and safety of tadalafil in men ≥75 years with lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) and additional safety in men ≥75 years with erectile dysfunction (ED). SUBJECTS AND METHODS: Integrated analysis of 12 Phase II-III randomised, double-blind and/or open-label extension studies to evaluate short-term (12-26 weeks) efficacy and short- and longer-term (42-52 weeks) safety in men <75 vs...
December 18, 2016: BJU International
https://www.readbyqxmd.com/read/27913813/-rehabilitation-after-hip-and-knee-endoprosthetic-treatment-in-the-elderly
#20
H Bork
Due to current demographic developments with a continuous increase in average life expectancy and improved medical treatment, the number of elderly patients with joint replacement of the lower extremities also has increased in recent years. Most of these patients have not only one but several chronic diseases requiring treatment and medication. Drug-drug interaction and functional restrictions of the elderly additionally reduce the postoperative psychophysical capacity; therefore, special knowledge in rehabilitative treatment and pain management is necessary...
January 2017: Der Orthopäde
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