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Drug interactions in the elderly

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https://www.readbyqxmd.com/read/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#1
Marta Gutiérrez-Valencia, Mikel Izquierdo, Vincenzo Malafarina, Javier Alonso-Renedo, Belén González-Glaría, Beatriz Larrayoz-Sola, María Pilar Monforte-Gasque, Pello Latasa-Zamalloa, Nicolás Martínez-Velilla
AIM: Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. METHODS: A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale...
April 19, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28408836/drug-related-problems-in-patients-with-erectile-dysfunctions-and-multiple-comorbidities
#2
Hasniza Zaman Huri, Chui Fang Ling, Azad Hassan Abdul Razack
This study was conducted in a tertiary medical center in Kuala Lumpur, Malaysia. A total of 200 erectile dysfunction (ED) patients with 499 cases who had received pharmacological treatments for their ED participated in this study. Types, causes and factors associated with drug-related problems (DRPs) in ED patients with multiple comorbidities were assessed. A total of 244 DRPs with an average of 1.2±2.1 DRPs per patient were identified. Drug interaction contributed the most to DRPs occurrence. There was a significant higher risk of DRPs in patients with benign prostatic hyperplasia, lower urinary tract infection and elderly and end-stage renal disease...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28407307/adenosine-a1-receptors-measured-with-11-c-mpdx-pet-in-early-parkinson-s-disease
#3
Masahiro Mishina, Kenji Ishii, Yuichi Kimura, Masahiko Suzuki, Shin Kitamura, Kenji Ishibashi, Muneyuki Sakata, Keiichi Oda, Shiro Kobayashi, Kazumi Kimura, Kiichi Ishiwata
Adenosine A1 receptors (A1 Rs) interact negatively with dopamine D1 receptors (D1 Rs) in neurons of the basal ganglia's direct pathway, while adenosine A2A receptors (A2A Rs) negatively interact with dopamine D2 receptors (D2 Rs) in indirect-pathway neurons. The aim of this study was to investigate the cerebral density of A1 Rs in Parkinson's disease (PD) in its early stages, using PET scans with the radioligand 8-dicyclopropylmethyl-1-(11) C-methyl-3-propylxanthine ((11) C-MPDX). We studied 10 drug-naïve patients with early PD...
April 13, 2017: Synapse
https://www.readbyqxmd.com/read/28405956/the-impact-of-polypharmacy-and-drug-interactions-among-the-elderly-population-in-western-sicily-italy
#4
Giulia Scondotto, Fanny Pojero, Sebastiano Pollina Addario, Mauro Ferrante, Maurizio Pastorello, Michele Visconti, Salvatore Scondotto, Alessandra Casuccio
AIM: Primary endpoint was to report polypharmacy distribution in the general population vs ≥65 years old people and to examine the frequency of drug-drug interactions (DDIs) in the Health Local Unit of Palermo, Italy, in relationship with patients' age. METHODS: Drug prescription data for the year 2014 were extracted from the database of the Local Health Unit of Palermo Province, Italy. Patients were divided into five age groups (0-13, 14-64, 65-69, 70-74, and ≥75 year old)...
April 12, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28401570/effect-of-p-glycoprotein-inhibition-at-the-blood-brain-barrier-on-brain-distribution-of-r-11-c-verapamil-in-elderly-versus-young-subjects
#5
Martin Bauer, Beatrix Wulkersdorfer, Rudolf Karch, Cécile Philippe, Walter Jäger, Johann Stanek, Wolfgang Wadsak, Marcus Hacker, Markus Zeitlinger, Oliver Langer
AIMS: The efflux transporter P-glycoprotein (ABCB1) restricts at the blood-brain barrier (BBB) distribution of many different drugs from blood to the brain. Previous data suggest an age-associated decrease in the expression and function of ABCB1 at the BBB. In this study we investigated the influence of age on the magnitude of an ABCB1-mediated drug-drug interaction (DDI) at the BBB. METHODS: We performed positron emission tomography (PET) scans with the model ABCB1 substrate (R)-[(11) C]verapamil in five young (26 ± 1 years, [mean ± standard deviation]) and five elderly (68 ± 6 years) healthy male volunteers before and after intravenous administration of a low dose of the ABCB1 inhibitor tariquidar (3 mg kg(-1) )...
April 12, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28392076/postmarketing-surveillance-studies-an-industry-perspective-on-changing-global-requirements-and-implications
#6
REVIEW
Arshadul Haque, Sajjan Daniel, Tricia Maxwell, Mariette Boerstoel
PURPOSE: This article describes postmarketing surveillance (PMS) study regulations and expectations of the regulatory agencies in 5 countries. With a focus on postapproval drug safety, there is a continuous need for understanding the benefit-risk profile of an approved drug. In addition to spontaneous adverse-event reporting, regulatory agencies seem to be more reliant on PMS studies. The opportunity to systematically monitor use in special populations, such as elderly patients and those with comorbid conditions, also presents itself during postmarketing use...
April 6, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28361440/acid-suppressive-therapy-and-risk-of-infections-pros-and-cons
#7
REVIEW
Leon Fisher, Alexander Fisher
This narrative review summarises the benefits, risks and appropriate use of acid-suppressing drugs (ASDs), proton pump inhibitors and histamine-2 receptor antagonists, advocating a rationale balanced and individualised approach aimed to minimise any serious adverse consequences. It focuses on current controversies on the potential of ASDs to contribute to infections-bacterial, parasitic, fungal, protozoan and viral, particularly in the elderly, comprehensively and critically discusses the growing body of observational literature linking ASD use to a variety of enteric, respiratory, skin and systemic infectious diseases and complications (Clostridium difficile diarrhoea, pneumonia, spontaneous bacterial peritonitis, septicaemia and other)...
March 30, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28345306/the-burden-and-management-of-cytochrome-p450-2d6-cyp2d6-mediated-drug-drug-interaction-ddi-co-medication-of-metoprolol-and-paroxetine-or-fluoxetine-in-the-elderly
#8
Muh Akbar Bahar, Eelko Hak, Jens H J Bos, Sander D Borgsteede, Bob Wilffert
PURPOSE: Metoprolol and paroxetine/fluoxetine are inevitably co-prescribed because cardiovascular disorders and depression often coexist in the elderly. This leads to CYP2D6-mediated drug-drug interactions (DDI). Because systematic evaluations are lacking, we assessed the burden of metoprolol-paroxetine/fluoxetine interaction in the elderly and how these interactions are managed in Dutch community pharmacies. METHOD: Dispensing data were collected from the University of Groningen pharmacy database (IADB...
March 26, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28344755/effect-of-topical-application-of-nigella-sativa-oil-and-oral-acetaminophen-on-pain-in-elderly-with-knee-osteoarthritis-a-crossover-clinical-trial
#9
Akram Kooshki, Reza Forouzan, Mohammad Hassan Rakhshani, Maryam Mohammadi
BACKGROUND: Limited evidence supports Nigella sativa's role as an effective complementary and alternative medicine and the anti-inflammatory effects of Nigella sativa on patients with allergic rhinitis. OBJECTIVE: The aim of this study was to investigate the effect of topical application of Nigella sativa oil and oral acetaminophen on pain in the elderly with knee osteoarthritis residing in a parents' home in Sabzevar. METHODS: This study is done as a crossover clinical trial...
November 2016: Electronic Physician
https://www.readbyqxmd.com/read/28340451/the-role-of-drug-drug-interactions-in-prostate-cancer-treatment-focus-on-abiraterone-acetate-prednisone-and-enzalutamide
#10
REVIEW
Marzia Del Re, Stefano Fogli, Lisa Derosa, Francesco Massari, Paul De Souza, Stefania Crucitta, Sergio Bracarda, Daniele Santini, Romano Danesi
Elderly patients with cancer may have comorbidities, each requiring additional pharmacologic treatment. Therefore, the occurrence of pharmacokinetic (PK) and pharmacodynamic (PD) interactions is very likely, and the risk of adverse reactions (ADRs), due to the narrow therapeutic window of anticancer drugs, is increased. Drug-drug interactions (DDIs) may occur in prostate cancer patients due to inhibition by abiraterone of liver cytochrome P450 (CYP)-dependent enzymes CYP2C8 and 2D6, which are involved in the metabolism of approximately 25% of all drugs, and induction by enzalutamide of CYP3A4, 2C9 and 2C19, which metabolize up to 50% of medications...
March 9, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28326532/common-drug-side-effects-and-drug-drug-interactions-in-elderly-adults-in-primary-care
#11
Susan E Merel, Douglas S Paauw
Prescribing medications, recognizing and managing medication side effects and drug interactions, and avoiding polypharmacy are all essential skills in the care of older adults in primary care. Important side effects of medications commonly prescribed in older adults (statins, proton pump inhibitors, trimethoprim-sulfamethoxazole and fluoroquinolone antibiotics, zolpidem, nonsteroidal antiinflammatory drugs, selective serotonin reuptake inhibitors, dipeptidyl peptidase 4 inhibitors) were reviewed. Important drug interactions with four agents or classes (statins, warfarin, factor Xa inhibitors, and calcium channel blockers) are discussed...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28273128/prevalence-risk-factors-and-health-outcomes-associated-with-polypharmacy-among-urban-community-dwelling-older-adults-in-multi-ethnic-malaysia
#12
Li Min Lim, Megan McStea, Wen Wei Chung, Nuruljannah Nor Azmi, Siti Azdiah Abdul Aziz, Syireen Alwi, Adeeba Kamarulzaman, Shahrul Bahyah Kamaruzzaman, Siew Siang Chua, Reena Rajasuriar
BACKGROUND: Polypharmacy has been associated with increased morbidity and mortality in the older population. OBJECTIVES: The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. METHODS: This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months)...
2017: PloS One
https://www.readbyqxmd.com/read/28260511/clinically-relevant-drug-interactions-with-anti-alzheimer-s-drugs
#13
Filippo Caraci, Janet Sultana, Filippo Drago, Edoardo Spina
The aging world population had led to an increase in the prevalence of Alzheimer's disease (AD). The drugs used to slow down the onset of AD, galantamine, donepezil, rivastigmine and memantine, are generally well-tolerated. However, drug interactions between these drugs and other drugs are an important aspect of patient safety that should be borne in mind, particularly given the high burden of polypharmacy in the elderly. The aim of this review is to provide an updated review of clinically significant drug-drug interactions concerning drugs approved for AD...
March 3, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28258476/psychomotor-agitation-following-treatment-with-hydroxychloroquine
#14
Ciro Manzo, Pietro Gareri, Alberto Castagna
We describe the case of an elderly woman with elderly-onset rheumatoid arthritis, where the use of 4 mg/kg/day of hydroxychloroquine (HCQ) was followed by the onset of psychomotor agitation with marked physical and verbal violence towards her partner, including throwing objects at her partner. No disturbance in sleep and no anxiety, nervousness, or irritability had emerged before the onset of her psychomotor agitation. The disappearance of agitation following targeted pharmacologic intervention and HCQ interruption, its re-onset after reintroduction of the drug, and the high score (9) of Naranjo's algorithm are surely linked to the existence of a causal relationship between HCQ and psychomotor agitation...
December 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/28258036/use-of-ace-inhibitors-and-falls-in-patients-with-parkinson-s-disease
#15
Alice Laudisio, Maria Rita Lo Monaco, Maria Caterina Silveri, Anna Rita Bentivoglio, Davide L Vetrano, Maria Stella Pisciotta, Vincenzo Brandi, Roberto Bernabei, Giuseppe Zuccalà
Falls represent a major concern in patients with Parkinson's disease (PD); however, currently acknowledged treatments for PD are not effective in reducing the risk of falling. The aim was to assess the association of use of ACE-inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) with falls among patients with PD. We analysed data of 194 elderly with PD attending a geriatric Day Hospital. Self-reported history of falls that occurred over the last year, as well as use of drugs, including ACEIs and angiotensin II receptor blockers (ARBs) were recorded...
February 22, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28257284/pharmacogenomics-and-tailored-polypharmacy-an-80-year-old-lady-with-rosuvastatin-associated-rhabdomyolysis-and-maprotiline-related-ogilvie-s-syndrome%C3%A2
#16
Katherina B Sreter, Blazenka Barisic, Sanja Popovic-Grle
What is known and objectives: Multiple adverse drug reactions (ADRs) are expected, and thus should be prevented in the elderly comorbid patient on polypharmacy. Rosuvastatin is commonly prescribed for the treatment and prevention of atherosclerotic diseases, and in rare cases, is associated with rhabdomyolysis. Maprotiline is a tetracyclic antidepressant, infrequently used in the United States, but seemingly more broadly in European countries. Acute colonic pseudo-obstruction (Ogilvie's syndrome) caused by maprotiline has thus far, to our knowledge, not yet been described in the literature...
March 3, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28238102/prevalence-of-drug-interactions-in-elderly-patients-with-multimorbidity-in-primary-care
#17
Susana Sánchez-Fidalgo, Maria Isabel Guzmán-Ramos, Mercedes Galván-Banqueri, Máximo Bernabeu-Wittel, Bernardo Santos-Ramos
Background Drug interactions (DIs) are a significant cause of medication-related problems. The aging population, high chronic diseases prevalence and polypharmacy are closely associated factors. Aim of the review To study the prevalence, types and associated factors of DIs in multimorbidity patients of over 65 years of age in primary care. Methods Relevant studies on DI prevalence in this population were reviewed in PubMed, Cochrane Library and EMBASE (January 2000-December 2015). Independent variables (duration, target population, age, sex, mean of drugs and diseases, geographical localization, DI databases used and study designs) and dependent variables (prevalence, number of DIs per 100 patients and per patient, number of clinically-relevant DIs per 100 patients, most common DI and associated factors) were classified for each article...
February 25, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28228653/drug-prescription-appropriateness-in-the-elderly-an-italian-study
#18
Nicola Allegri, Federica Rossi, Federica Del Signore, Paolo Bertazzoni, Roberto Bellazzi, Giorgio Sandrini, Tomaso Vecchi, Davide Liccione, Alessia Pascale, Stefano Govoni
PURPOSE: Correct drug prescription in the elderly is a difficult task that requires careful survey of the current pharmacological therapies. In this article, we reviewed the drug prescriptions provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy. METHODS: Subjects were recruited from a local nursing home, the Pavia and Vigevano Neuropsychological Center for Alzheimer's Disease, general practitioners' offices, and the local University of the Third Age...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28218801/do-cancer-survivors-change-their-prescription-drug-use-for-financial-reasons-findings-from-a-nationally-representative-sample-in-the-united-states
#19
Zhiyuan Zheng, Xuesong Han, Gery P Guy, Amy J Davidoff, Chunyu Li, Matthew P Banegas, Donatus U Ekwueme, K Robin Yabroff, Ahmedin Jemal
BACKGROUND: There is limited evidence from nationally representative samples about changes in prescription drug use for financial reasons among cancer survivors in the United States. METHODS: The 2011 to 2014 National Health Interview Survey was used to identify adults who reported ever having been told they had cancer (cancer survivors; n = 8931) and individuals without a cancer history (n = 126,287). Measures of changes in prescription drug use for financial reasons included: 1) skipping medication doses, 2) taking less medicine, 3) delaying filling a prescription, 4) asking a doctor for lower cost medication, 5) buying prescription drugs from another country, and 6) using alternative therapies...
February 20, 2017: Cancer
https://www.readbyqxmd.com/read/28211099/sedation-with-orally-administered-midazolam-in-elderly-dental-patients-with-major-neurocognitive-disorder
#20
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
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