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Drug interactions in the elderly

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https://www.readbyqxmd.com/read/28716467/clinically-relevant-potential-drug-drug-interactions-among-outpatients-a-nationwide-database-study
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
June 27, 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
#7
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...
June 26, 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28571163/utilization-pattern-of-potentially-inappropriate-medications-in-geriatric-patients-in-a-tertiary-care-hospital-a-retrospective-observational-study
#15
Rajal Sudhir Narvekar, Nikhil Narayan Bhandare, Jonathan Joaquim Gouveia, Padma Narayan Bhandare
INTRODUCTION: Geriatric population is on the rise throughout the world, hence the quality and the safety of prescribing in the elderly is a global healthcare concern. It is important for the healthcare providers to be aware of the limitations in prescribing certain drugs to the elderly. This study was an attempt to shed light on the utilization pattern of Potentially Inappropriate Medications (PIMs) in elderly patients admitted in the medicine wards in a tertiary care hospital in Goa...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28556195/use-of-nystatin-and-chlorhexidine-in-oral-medicine-properties-indications-and-pitfalls-with-focus-on-geriatric-patients
#16
REVIEW
Elusa Scheibler, Maria Claudia Rosa Garcia, Renata Medina da Silva, Maria Antonia Figueiredo, Fernanda Gonçalves Salum, Karen Cherubini
OBJECTIVES: The aim of this work was to review the scientific literature on the properties, indications and pitfalls related to nystatin and chlorhexidine in oral medicine and also to compare these to other topical antifungal agents, considering the elderly population. BACKGROUND: Nystatin is a polyene antifungal widely used as a topical formulation to treat candidiasis, whereas chlorhexidine is a wide-spectrum antimicrobial, especially used against bacteria, but also effective in treating some fungal infections including those caused by Candida spp...
May 29, 2017: Gerodontology
https://www.readbyqxmd.com/read/28533886/a-case-management-of-hypertension-in-the-elderly-in-sub-sahara-africa-lessons-from-granny
#17
Ahmadou Musa Jingi, Liliane Mfeukeu Kuate, Jean Jacques Noubiap
Management of chronic disease conditions in the elderly is challenging. They usually have many co-morbidities requiring multiple drug regimens, and memory or cognitive problems that can interfere with management. Also, they sometimes have a degree of social problems as they might often live alone, and thereby cater for their daily activities with minimal assistance. Multiple drug use combined with their fragile health predispose them to adverse drug reactions, drug-drug interactions, and direct drug toxicity from overdosing...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28527149/characterisation-of-drug-related-problems-and-associated-factors-at-a-clinical-pharmacist-service-na%C3%A3-ve-hospital-in-northern-sweden
#18
Cecilia Peterson, Maria Gustafsson
BACKGROUND: Polypharmacy and increased sensitivity to side effects cause adverse drug events, drug-drug interactions and medication errors in the elderly. OBJECTIVE: The objective of this study was to investigate the prevalence and type of drug-related problems and associated factors among patients admitted to a clinical pharmacist service-naïve medical ward in an inland hospital in northern Sweden. METHODS: During September-November 2015 and February-April 2016, clinical pharmacists working as part of a ward team on the medical ward conducted 103 medication reviews...
June 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28527083/shared-mechanisms-of-epilepsy-migraine-and-affective-disorders
#19
Davide Zarcone, Simona Corbetta
Since the nineteenth century several clinical features have been observed in common between migraine and epilepsy (such as episodic attacks, triggering factors, presence of aura, frequent familiarity), but only in recent years researchers have really engaged in finding a common pathogenic mechanism. From studies of disease incidence, we understand how either migraine among patients with epilepsy or epilepsy among migraine patients are more frequent than in the general population. This association may result from a direct causality, by the same environmental risk factors and/or by a common genetic susceptibility...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28511403/a-prospective-analysis-of-drug-interactions-in-patients-of-intensive-cardiac-care-unit
#20
Shipra Jain, Pushpawati Jain, Kopal Sharma, Pushpendra Saraswat
INTRODUCTION: Drug-Drug Interaction (DDI) is a serious concern in cardiac patients due to polypharmacy. AIM: The present study was aimed to identify the potential DDI among hospitalized cardiac patients and evaluate the mechanism and severity of such interactions. MATERIALS AND METHODS: A prospective observational study was conducted in intensive cardiac care unit of a tertiary care hospital for six months. Patients aged 18 years and above and taking two or more drugs were included in the study...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
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