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Drug interactions in the elderly

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https://www.readbyqxmd.com/read/29648464/home-blood-pressure-and-cardiovascular-outcomes-in-very-elderly-patients-receiving-antihypertensive-drug-therapy-a-subgroup-analysis-of-home-blood-pressure-measurement-with-olmesartan-naive-patients-to-establish-standard-target-blood-pressure-honest-study
#1
Ikuo Saito, Kazuomi Kario, Toshio Kushiro, Satoshi Teramukai, Mai Yaginuma, Natsuko Zenimura, Yoshihiro Mori, Yasuyuki Okuda, Kazuyuki Shimada
The appropriate target blood pressure (BP) in elderly patients with hypertension remains uncertain. We investigated the relationship between morning home systolic blood pressure (MHSBP) during follow-up and cardiovascular (CV) risk in outpatients receiving olmesartan-based treatment aged <75 years (n = 16799) and ≥75 years (n = 4792) in the HONEST study. In the follow-up period (mean 2.02 years), the risk for major CV events was significantly higher in patients with MHSBP ≥155 mmHg compared with <125 mmHg in both age groups in Cox proportional hazards model adjusted for other risk factors and there was no significant difference in trend between the two groups (interaction P = 0...
March 28, 2018: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29625926/oral-pharmacologic-management-of-overactive-bladder-syndrome-where-do-we-stand
#2
REVIEW
Tom Marcelissen, Tina Rashid, Tiago Antunes Lopes, Nicolas Barry Delongchamps, Bogdan Geavlete, Malte Rieken, Jean-Nicolas Cornu, Mohammad Sajjad Rahnama'i
Overactive bladder syndrome (OAB) is a prevalent disorder with a significant impact on quality of life. Despite this high prevalence, there is significant underdiagnosis and undertreatment due to several barriers, including embarrassment, poor communication and low patient adherence. Currently, various antimuscarinic are available in the treatment of OAB. The introduction of mirabegron has broadened the therapeutic approach and combination therapy of both agents can be valuable in clinical practice. Yet, patient adherence to most drugs for OAB is still relatively poor...
April 3, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29602745/implementation-of-a-pharmacist-led-pharmacogenomics-service-for-the-program-of-all-inclusive-care-for-the-elderly-pharm-genome-pace
#3
Kevin T Bain, Emily J Schwartz, Orsula V Knowlton, Calvin H Knowlton, Jacques Turgeon
OBJECTIVES: To determine the feasibility of implementing a pharmacist-led pharmacogenomics (PGx) service for the Program of All-Inclusive Care for the Elderly (PACE). SETTING: A national centralized pharmacy providing PGx services to community-based PACE centers. PRACTICE DESCRIPTION: Individuals 55 years of age and older enrolled in PACE who underwent PGx testing as part of their medical care (n = 296). PRACTICE INNOVATION: Pharmacist-led PGx testing, interpreting, and consulting...
March 27, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29593860/potential-drug-drug-interactions-with-direct-oral-anticoagulants-in-elderly-hospitalized-patients
#4
Heather L Forbes, Thomas M Polasek
Background: To determine the prevalence and nature of potential drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs) in elderly hospitalized patients. Methods: This was a retrospective observational study. Inclusion criteria were: aged over 65 years; taking apixaban, rivaroxaban or dabigatran; and admitted to the Repatriation General Hospital between April 2014 and July 2015. A list of clinically relevant 'perpetrator' drugs was compiled from product information, the Australian Medicines Handbook, the Australian National Prescribing Service resources, and local health network guidelines...
October 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29589066/potentially-inappropriate-medication-in-the-elderly-a-systematic-review-of-validated-explicit-criteria
#5
REVIEW
Fabiane Raquel Motter, Janaína Soder Fritzen, Sarah Nicole Hilmer, Érika Vieira Paniz, Vera Maria Vieira Paniz
PURPOSE: Potentially inappropriate medication (PIM) use causes preventable adverse drug reactions in older patients. Several assessment tools have been published to identify and avoid PIM use. In this systematic literature review, we aim to provide summaries and comparisons of validated PIMs lists published between 1991 and 2017 internationally. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), we performed a systematic review of articles describing the development and validation of criteria for identification of PIMs among older people published between January 1991 and April 2017...
March 27, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29575226/discontinuation-and-dose-adjustment-of-metoprolol-after-metoprolol-paroxetine-fluoxetine-co-prescription-in-dutch-elderly
#6
Muh Akbar Bahar, Yuanyuan Wang, Jens H J Bos, Bob Wilffert, Eelko Hak
PURPOSE: Co-prescription of paroxetine/fluoxetine (a strong CYP2D6 inhibitor) in metoprolol (a CYP2D6 substrate) users is common, but data on the clinical consequences of this drug-drug interaction are limited and inconclusive. Therefore, we assessed the effect of paroxetine/fluoxetine initiation on the existing treatment with metoprolol on the discontinuation and dose adjustment of metoprolol among elderly. METHODS: We performed a cohort study using the University of Groningen IADB...
March 24, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29566917/therapeutic-challenges-in-the-mature-patient
#7
Zrinka Bukvić Mokos, Anamaria Jović, Romana Čeović, Krešimir Kostović, Ivica Mokos, Branka Marinović
With the tremendous increase in the proportion of seniors in the global population, geriatric health care has become of greater interest and concern. Increased emphasis on geriatric medicine, along with the growth in the development of age-related skin disorders, has led to particular attention for geriatric, dermatology and dermatopharmacology. An aging population has brought many therapeutic challenges that we need to recognize and overcome by applying geropharmacologic principles. The purpose of this paper is to inform dermatologists of the age-related changes in the pharmacokinetics of common dermatologic drugs, their various interactions potentially occurring in the elderly, and the principles and evidence-based strategies for detection, management, and prevention to improve medication adherence...
March 2018: Clinics in Dermatology
https://www.readbyqxmd.com/read/29559030/effect-of-ssri-and-calcium-channel-blockers-on-depression-symptoms-and-cognitive-function-in-elderly-persons-treated-for-hypertension-three-city-cohort-study
#8
Phillip J Tully, Ruth Peters, Karine Pérès, Kaarin J Anstey, Christophe Tzourio
BACKGROUND: Emerging genetic, ex-vivo, and clinical trial evidence indicates that calcium channel blockers (CCB) can improve mood and cognitive function. The objective of this study was to examine the effect of selective serotonin reuptake inhibitor (SSRI) therapy augmented with CCB on depression and cognitive decline in an elderly population with hypertension. METHODS: Prospective study of 296 persons treated with SSRI and antihypertensive drugs. Baseline and two year clinic assessments were used to categorize participants as users of SSRI + CCB (n = 53) or users of SSRI + other antihypertensives (n = 243)...
March 21, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29557529/clinical-pharmacokinetics-and-drug-drug-interactions-of-elbasvir-grazoprevir
#9
Tony K L Kiang
Elbasvir and grazoprevir, in a fixed-dose combination of 50 and 100 mg, respectively, have received approval to be administered orally once daily, with or without ribavirin, for the treatment of chronic hepatitis C virus (HCV) infections. The absorption characteristics of elbasvir and grazoprevir have been adequately summarized, although differences were observed for grazoprevir (e.g., increased exposure at steady state in patients), but not elbasvir, between healthy and HCV-infected subjects. Inconsistencies with respect to absorption were also reported on the effects of food or acid reducers (famotidine or pantoprazole) in the literature...
March 20, 2018: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29551440/racing-the-clock-the-role-of-circadian-rhythmicity-in-addiction-across-the-lifespan
#10
REVIEW
Danielle Gulick, Joshua J Gamsby
Although potent effects of psychoactive drugs on circadian rhythms were first described over 30 years ago, research into the reciprocal relationship between the reward system and the circadian system - and the impact of this relationship on addiction - has only become a focus in the last decade. Nonetheless, great progress has been made in that short time toward understanding how drugs of abuse impact the molecular and physiological circadian clocks, as well as how disruption of normal circadian rhythm biology may contribute to addiction and ameliorate the efficacy of treatments for addiction...
March 15, 2018: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29544975/-pharmacokinetic-risk-factors-of-beta-blockers-overdose-in-the-elderly-case-report-and-pharmacology-approach
#11
L Lafarge, L Bourguignon, N Bernard, T Vial, M-J Dehan-Moya, B De La Gastine, S Goutelle
Beta-blockers are widely prescribed in elderly patients and may induce severe adverse drug reactions. We report a case of bisoprolol-induced bradycardia in an elderly patient with impaired renal function and use of cytochrome P450 inhibitors. A literature review has been performed in order to analyze pharmacokinetic risk factors of beta-blockers overdosing in geriatrics. Various mechanisms can result in decreased elimination of beta-blockers. These mechanisms vary according to the beta-blocker agent and may be combined in some individuals, especially elderly patients...
March 12, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29534557/a-challenge-to-aging-society-by-microrna-in-extracellular-vesicles-microrna-in-extracellular-vesicles-as-promising-biomarkers-and-novel-therapeutic-targets-in-multiple-myeloma
#12
REVIEW
Tomofumi Yamamoto, Nobuyoshi Kosaka, Yutaka Hattori, Takahiro Ochiya
Multiple myeloma (MM) is a malignancy of terminally differentiated plasma cells and is the second most common hematological cancer. MM frequently occurs in the elderly population with the median age as the middle sixties. Over the last 10 years, the prognosis of MM has been dramatically improved by new therapeutic drugs; however, MM is still incurable. The pathogenesis of MM is still unclear, thus greater understanding of the molecular mechanisms of MM malignancy is desirable. Recently, microRNAs (miRNAs) were shown to modulate the expression of genes critical for MM pathogenesis...
March 12, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29521554/improving-medication-appropriateness-in-nursing-home-residents-by-enhancing-interprofessional-cooperation-a-study-protocol
#13
Dagmar Schaffler-Schaden, Stefan Pitzer, Magdalena Schreier, Johanna Dellinger, Beate Brandauer-Stickler, Miriam Lainer, Maria Flamm, Jürgen Osterbrink
Polypharmacy in elderly people is an increasing challenge for health professionals. Drug-Drug interactions, dosing or administration errors can cause preventable incidents and hospitalizations. Due to chronic illness and multi-morbidity, older people are considered as a particularly vulnerable group of patients. Furthermore, it is well known that communication between health professionals is often insufficient. The aim of this study is to improve the appropriateness of medication of nursing home residents by establishing a long-term structured medication review process and to enhance the interprofessional communication between general practitioners (GPs), nurses and pharmacists...
March 9, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29521003/daily-sodium-intake-influences-the-relationship-between-angiotensin-converting-enzyme-gene-insertion-deletion-polymorphism-and-hypertension-in-older-adults
#14
Ivna V Freire, Cezar A Casotti, Ícaro J S Ribeiro, Jonas R D Silva, Ana A L Barbosa, Rafael Pereira
The angiotensin-converting enzyme insertion/deletion (I/D) gene polymorphism has been widely reported as being associated with hypertension; however, most studies do not consider environmental/behavioral factors. This study aimed to investigate the relationship among angiotensin-converting enzyme insertion/deletion gene polymorphism, environmental/behavioral factors, and hypertension in community-dwelling elderly individuals. All community-dwelling older adults from Aiquara, Bahia, Brazil, were invited to take part in this study...
March 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29505505/a-case-report-with-shock-induced-by-tolvaptan-in-an-elderly-patient-with-congestive-heart-failure
#15
Zhi-Gang Zhang, Xin-Min Liu
RATIONALE: Tolvaptan (TLV) is a new vasopressin type 2 receptor antagonist effective in patients with heart failure (HF). Accumulating evidences have revealed that treatment with TLV does not alter the blood pressure significantly. PATIENT CONCERNS: An 84-year-old man was diagnosed with acute exacerbation of chronic HF due to ischemic cardiomyopathy, arrhythmia, mitral and aortic regurgitation. Treatment with TLV increased the urine volume and improved the dyspnea...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29503430/-drug-drug-interactions-with-consideration-of-pharmacogenetics
#16
Shogo Ozawa
 Elderly patients often suffer from a variety of diseases and therefore may be prescribed several kinds of drugs. Interactions between these drugs may cause problems in some patients. Guidelines for drug interactions were released on July 8, 2014 "Drug Interaction Guideline for Drug Development and Labeling Recommendations (Final Draft)". These guidelines include the theoretical basis for evaluating the mechanisms of drug interaction, the possible extent of drug interactions, and take into consideration special populations (e...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29493375/tdm-in-psychiatry-and-neurology-a-comprehensive-summary-of-the-consensus-guidelines-for-therapeutic-drug-monitoring-in-neuropsychopharmacology-update-2017-a-tool-for-clinicians
#17
Georgios Schoretsanitis, Michael Paulzen, Stefan Unterecker, Markus Schwarz, Andreas Conca, Gerald Zernig, Gerhard Gründer, Ekkerhard Haen, Pierre Baumann, Niels Bergemann, Hans Willi Clement, Katharina Domschke, Gabriel Eckermann, Karin Egberts, Manfred Gerlach, Christine Greiner, Ursula Havemann-Reinecke, Gudrun Hefner, Renate Helmer, Ger Janssen, Eveline Jaquenoud-Sirot, Gerd Laux, Thomas Messer, Rainald Mössner, Matthias J Müller, Bruno Pfuhlmann, Peter Riederer, Alois Saria, Bernd Schoppek, Margarete Silva Gracia, Benedikt Stegmann, Werner Steimer, Julia C Stingl, Manfred Uhr, Sven Ulrich, Roland Waschgler, Gabriela Zurek, Christoph Hiemke
OBJECTIVES: Therapeutic drug monitoring (TDM) combines the quantification of drug concentrations in blood, pharmacological interpretation and treatment guidance. TDM introduces a precision medicine tool in times of increasing awareness of the need for personalized treatment. In neurology and psychiatry, TDM can guide pharmacotherapy for patient subgroups such as children, adolescents, pregnant women, elderly patients, patients with intellectual disabilities, patients with substance use disorders, individuals with pharmacokinetic peculiarities and forensic patients...
April 2018: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/29493093/highlights-of-the-2017-european-aids-clinical-society-eacs-guidelines-for-the-treatment-of-adult-hiv-positive-persons-version-9-0
#18
L Ryom, C Boesecke, M Bracchi, J Ambrosioni, A Pozniak, J Arribas, G Behrens, Pgm Mallon, M Puoti, A Rauch, J M Miro, O Kirk, C Marzolini, J D Lundgren, M Battegay
BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. GUIDELINE HIGHLIGHTS: Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management...
March 1, 2018: HIV Medicine
https://www.readbyqxmd.com/read/29488058/fatal-intoxication-with-antidepressants-a-case-with-many-culprits
#19
Antonis Goulas, Nikolaos Raikos, Diamantis Krokos, Orthodoxia Mastrogianni, Amvrosios Orphanidis, Konstantinos Zisopoulos, Androniki Tsepa
Serotonin-specific reuptake inhibitors (SSRIs) are generally considered safe drugs but fatal adverse effects do sometimes occur, often as a consequence of interactions with other serotonin active drugs. Polypharmacy is usually a problem that the elderly encounter, but it can also have dire consequences for young people, especially when an underlying heart condition is present. Thus, failure to diagnose heart disease and the use of contraindicated medications can be a lethal combination, irrespective of age...
February 27, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29471572/-cardiovascular-medication-in-elderly-patients
#20
Robert H G Schwinger
Elderly people show increased probability to develop atherosclerotic diseases; in consequence heart failure - most often following coronary heart disease - as well as atrial fibrillation is more common. Following guidelines may lead to polypharmacy, i. e. use of more than 5 drugs daily. Thus, drug interactions as well as side effects become more likely; especially in elderly patients reduced kidney function has to be taken into account. Only drugs which have shown to prolong life or to reduce symptoms in controlled clinical trials should be used...
February 2018: Deutsche Medizinische Wochenschrift
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