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Drug interactions in the elderly

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https://www.readbyqxmd.com/read/27913813/-rehabilitation-after-hip-and-knee-endoprosthetic-treatment-in-the-elderly
#1
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...
December 2, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27885844/guidance-to-manage-inappropriate-polypharmacy-in-older-people-systematic-review-and-future-developments
#2
Derek Stewart, Alpana Mair, Martin Wilson, Przemyslaw Kardas, Pawel Lewek, Albert Alonso, Jennifer McIntosh, Katie MacLure
Single disease state led evidence-based guidelines do not provide sufficient coverage of issues of multimorbidities, with the cumulative impact of recommendations often resulting in overwhelming medicines burden. Inappropriate polypharmacy increases the likelihood of adverse drug events, drug interactions and non-adherence. Areas covered: A detailed description of a pan-European initiative, 'Stimulating Innovation Management of Polypharmacy and Adherence in the Elderly, SIMPATHY', which is a project funded by the European Commission to support innovation across the European Union...
November 25, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27875918/expected-and-actual-adverse-drug-drug-interactions-in-elderly-patients-accessing-the-emergency-department-data-from-the-ancestral-ed-study
#3
A Marino, A Capogrosso-Sansone, M Tuccori, G Bini, V Calsolaro, S Mantarro, I Convertino, G Pasqualetti, E Orsitto, M Santini, F Monzani, C Blandizzi
OBJECTIVE: This study was aimed at evaluating the frequency and describing the adverse drug-drug interactions (DDIs) recorded among elderly patients accessing the emergency department (ED). METHODS: Patients aged ≥65 years, accessing the ED of Pisa University Hospital (Italy) from 1 January 2015 to 31 December 2015 within the ANCESTRAL-ED program, were included in this study. 'Expected' DDIs were assessed using Thomson Micromedex®. Each ED admission (discharge diagnosis) consistent with the signs and symptoms of an expected DDI for each patient was classified as an 'actual' DDI...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27872943/-adverse-drug-reactions-in-elderly-people-first-data-from-the-leipzig-research-center-for-civilization-diseases-life
#4
REVIEW
R Treudler, F Walther, P Ahnert, J-C Simon
BACKGROUND: Few data exist on adverse drug reactions (ADR) in elderly people. In this group, pharmacotherapy represents a challenge with regard to comorbidities, drug interactions and compliance. OBJECTIVE: The aim of this article is to highlight the characteristics of ADR in elderly patients. METHODS: In addition to a literature review we present the first data from the Leipzig Research Center for Civilization Diseases (LIFE). Between 2011 and 2015 a total of 9537 subjects aged 40-79 years were randomly included in this population-based, age and sex standardized investigation in the inhabitants of Leipzig, Germany and special emphasis was placed on allergies including questions with regard to ADR...
November 21, 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/27869892/-anmco-position-paper-use-of-new-oral-anticoagulants-for-the-treatment-and-prevention-of-pulmonary-thromboembolism
#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 1) their mechanism of action, pharmacodynamics and pharmacokinetics; 2) the use in the acute phase with the "double drug single dose" approach or with "single drug double dose"; 3) the use in the extended phase with demonstrated efficacy and with low incidence of bleeding events; 4) 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); 5) they propose a possible laboratory clinical pathway for follow-up; 6) carry out an examination on the main drug interactions, their potential bleeding risk, and the way to deal with some bleeding complications...
September 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27828578/diabetes-in-the-elderly-drug-use-and-the-risk-of-drug-interaction
#6
Maria Aparecida Medeiros Barros do Prado, Priscila Maria Stolses Bergamo Francisco, Marilisa Berti de Azevedo Barros
This study sought to outline the sociodemographic and health profile of elderly persons with reported diabetes, to assess the knowledge and practices regarding treatment options and describe the use of medications and potential risks for drug interactions (DI) in this subgroup. In 2008,a cross-sectional study was conducted of 1,517 elderly citizens in Campinas in which the prevalence of diabetes was estimated and its associations assessed using the Rao-Scott test (p < 0,05).The potential drug interactions were evaluated using the Micromedex® database...
November 2016: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/27825371/effective-and-safe-proton-pump-inhibitor-therapy-in-acid-related-diseases-a-position-paper-addressing-benefits-and-potential-harms-of-acid-suppression
#7
EDITORIAL
Carmelo Scarpignato, Luigi Gatta, Angelo Zullo, Corrado Blandizzi
BACKGROUND: The introduction of proton pump inhibitors (PPIs) into clinical practice has revolutionized the management of acid-related diseases. Studies in primary care and emergency settings suggest that PPIs are frequently prescribed for inappropriate indications or for indications where their use offers little benefit. Inappropriate PPI use is a matter of great concern, especially in the elderly, who are often affected by multiple comorbidities and are taking multiple medications, and are thus at an increased risk of long-term PPI-related adverse outcomes as well as drug-to-drug interactions...
November 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27822619/the-5-lidocaine-medicated-plaster-its-inclusion-in-international-treatment-guidelines-for-treating-localized-neuropathic-pain-and-clinical-evidence-supporting-its-use
#8
REVIEW
Ralf Baron, Massimo Allegri, Gerardo Correa-Illanes, Guy Hans, Michael Serpell, Gerard Mick, Victor Mayoral
When peripheral neuropathic pain affects a specific, clearly demarcated area of the body, it may be described as localized neuropathic pain (LNP). Examples include postherpetic neuralgia and painful diabetic neuropathy, as well as post-surgical and post-traumatic pain. These conditions may respond to topical treatment, i.e., pharmaceutical agents acting locally on the peripheral nervous system, and the topical route offers advantages over systemic administration. Notably, only a small fraction of the dose reaches the systemic circulation, thereby reducing the risk of systemic adverse effects, drug-drug interactions and overdose...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27789954/use-of-ics-laba-extra-fine-and-non-extra-fine-in-elderly-asthmatics
#9
REVIEW
Alida Benfante, Marco Basile, Salvatore Battaglia, Mario Spatafora, Nicola Scichilone
Age represents an exclusion criterion in randomized clinical trials designed to test the efficacy and safety of inhaled drugs in asthma. As a consequence, data on efficacy and safety of inhaled corticosteroid (ICS) and long-acting β2 agonist (LABA) combinations in elderly asthmatics are scanty. Older age is associated with an increased proportion of comorbid conditions; in addition, all organ functions undergo a process of senescence, thus reducing their ability to metabolize the agents. Overall, these age-associated conditions may variably, and often unpredictably, affect the metabolism and excretion of respiratory drugs...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27787263/serum-alanine-aminotransferase-levels-and-all-cause-mortality
#10
Erica Karaphillis, Ryan Goldstein, Sharif Murphy, Rehan Qayyum
BACKGROUND AND OBJECTIVES: Studies have examined the relationship between serum alanine aminotransferase (ALT) and mortality with inconsistent results. Our aims were to examine the association of normal range serum ALT with mortality, to explore a nonlinear relationship between ALT and mortality, and to investigate whether age modifies this relationship. STUDY: We used the continuous National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. Vital status of the participants was obtained by probabilistic matching between NHANES and the National Death Index...
October 26, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27781063/efficacy-and-safety-of-novel-anticoagulants-in-the-elderly
#11
REVIEW
Nikolaos Karamichalakis, Stamatis Georgopoulos, Konstantinos Vlachos, Ioannis Liatakis, Michael Efremidis, Antonios Sideris, Konstantinos P Letsas
Atrial fibrillation and venous thromboembolism (VTE) are common disorders associated with maleficent thrombotic events, particularly in the elderly patients. Polypharmacy, co-morbidities, and altered pharmacokinetics, often present in these patients, render the use of anticoagulants quite challenging. Novel oral anticoagulants (NOACs) have recently emerged as alternatives to Vitamin K Antagonists (VKAs) and are gradually increasing their popularity mainly because of their fewer drug and food interactions and ease of use...
August 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27765795/disseminated-infections-with-antibiotic-resistant-non-typhoidal-salmonella-strains-contributions-of-host-and-pathogen-factors
#12
Kristen L Lokken, Gregory T Walker, Renée M Tsolis
Non-typhoidal Salmonella enterica serovars (NTS) are generally associated with gastroenteritis; however, the very young and elderly, as well as individuals with compromised immunity, are at risk of developing disseminated infection that can manifest as bacteremia or focal infections at systemic sites. Disseminated NTS infections can be fatal and are responsible for over 600,000 deaths annually. Most of these deaths are in sub-Saharan Africa, where multi-drug resistant NTS clones are currently circulating in a population with a high proportion of individuals that are susceptible to disseminated disease...
October 8, 2016: Pathogens and Disease
https://www.readbyqxmd.com/read/27761112/hospitalizations-due-to-adverse-drug-events-in-the-elderly-a-retrospective-register-study
#13
Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27751854/evaluation-of-the-in%C3%A2-vitro-and-in%C3%A2-vivo-metabolic-pathway-and-cytochrome-p450-inhibition-induction-profile-of-huperzine-a
#14
Ping-Ping Lin, Xue-Ning Li, Fei Yuan, Wei-Li Chen, Meng-Jie Yang, Hong-Rong Xu
Huperzine A (HupA), one of the reversible and selective acetylcholinesterase inhibitors derived from Chinese herb Huperzia Serrata, possesses affirmative action of ameliorating cognitive dysfunction of Alzheimer's disease. Up to now, the effects of HupA on human cytochrome P450s (CYPs) have not been fully elucidated. The purpose of the present study was to clarify the metabolic pathway of HupA in vitro and in vivo, and to evaluate the CYPs inhibition/induction profile of HupA in vitro. The catalytic activity of CYP enzymes (CYP1A2, 2A6, 2C9, 2C19, 2D6, 2E1 and 3A4) was measured by the quantification of specific enzyme substrates using validated liquid chromatography-tandem mass spectrometry (LC/MS/MS) methods...
November 11, 2016: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/27738376/paroxetine-the-antidepressant-from-hell-probably-not-but-caution-required
#15
Robert M Nevels, Samuel T Gontkovsky, Bryman E Williams
Paroxetine, also known by the trade names Aropax, Paxil, Pexeva, Seroxat, Sereupin and Brisdelle, was first marketed in the U.S. in 1992. Effective for major depression and various anxiety disorders, it quickly gained a sizable share of the antidepressant prescription market. By the late 1990s, paroxetine frequently was being associated with serious drug interactions and medication side effects. Most significantly, in a major Canadian epidemiological study examining the relationship between antidepressants and diseases, paroxetine was associated with a 620 percent increase in the rate of breast cancer in women who had taken it over a four-year period...
March 1, 2016: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/27734707/-polypharmacy-viewed-not-only-through-the-prism-of-multi-morbidity-but-also-as-an-independent-geriatric-syndrome
#16
Pavel Weber, Hana Meluzínová, Dana Prudius, Katarína Bielaková
Polypharmacy is common in the elderly, especially in the late age (over 75 years). Usually it is closely related to the geriatric multi-morbidity. The authors highlight the medication used in the anticipated positive and potential negative potential. While physicians often must make difficult trade-offs between the guidelines on one hand and complicated multi-morbidity, on the other hand, while trying to avoid polypharmacy ( 5 drugs), especially excessive polypharmacy ( 10 drugs). Multimorbid elderly patients who are treated in accordance with guidelines typically use large amounts of medicaments...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27721636/polytherapy-and-drug-interactions-in-elderly
#17
Hima Bindu Gujjarlamudi
There is an increase in population of elderly above the age of 65. As age advances, more diseases develop resulting in use of more medications. Physiological changes, alterations in homeostatic regulation and diseases modify pharmacokinetics and drug response in older patients. The risk for drug interactions and drug-related problems increases along with multiple medications. Periodic evaluation of the patients' drug regimen is essential to minimize polytherapy. Clinicians must be alert to the use of herbal and dietary supplements as they are prone to drug-drug interactions...
July 2016: Journal of Mid-life Health
https://www.readbyqxmd.com/read/27716084/quinine-induced-simvastatin-toxicity-through-cytochrome-inhibition-a-case-report
#18
Johannes M Just, Klaus Weckbecker, Katja S Just
BACKGROUND: Nocturnal leg cramps are painful, involuntary muscle contractions commonly seen in elderly. While mostly harmless, they can severely impair quality of life and often disrupt sleep. Adverse drug effects may be responsible for a fraction of nocturnal leg cramps but often go unrecognized, resulting in additional prescribing intended to deal with adverse effects that might be better addressed by reduction, substitution, or discontinuation of the offending agent. CASE PRESENTATION: An 87 year old female presented as outpatient in family medicine with nocturnal leg cramps which had been present for five years and increasingly burdened her quality of life...
October 1, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27686164/contribution-of-four-lifelong-factors-of-cognitive-reserve-on-late-cognition-in-normal-aging-and-parkinson-s-disease
#19
Maud Rouillard, Michel Audiffren, Cédric Albinet, Mohamed Ali Bahri, Gaëtan Garraux, Fabienne Collette
INTRODUCTION: Cognitive reserve (CR) was proposed to explain how individual differences in brain function help to cope with the effects of normal aging and neurodegenerative diseases. Education, professional solicitations, and engagement in leisure and physical activities across the lifetime are considered as major determinants of this reserve. METHOD: Using multiple linear regression analyses, we tested separately in healthy elderly and Parkinson's disease (PD) populations to what extent cognitive performance in several domains was explained by (a) any of these four environmental lifespan variables; (b) demographic and clinical variables (age, gender, depression score, and, for the PD group, duration of disease and dopaminergic drugs)...
August 12, 2016: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/27670781/host-cytoskeleton-in-respiratory-syncytial-virus-assembly-and-budding
#20
Shadi Shahriari, James Gordon, Reena Ghildyal
Respiratory syncytial virus (RSV) is one of the major pathogens responsible for lower respiratory tract infections (LRTI) in young children, the elderly, and the immunosuppressed. Currently, there are no antiviral drugs or vaccines available that effectively target RSV infections, proving a significant challenge in regards to prevention and treatment. An in-depth understanding of the host-virus interactions that underlie assembly and budding would inform new targets for antiviral development.Current research suggests that the polymerised form of actin, the filamentous or F-actin, plays a role in RSV assembly and budding...
September 26, 2016: Virology Journal
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