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Drug interactions in the elderly

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https://www.readbyqxmd.com/read/29033825/acute-stress-affects-the-expression-of-hippocampal-mu-oscillations-in-an-age-dependent-manner
#1
Samir Takillah, Jérémie Naudé, Steve Didienne, Claude Sebban, Brigitte Decros, Esther Schenker, Michael Spedding, Alexandre Mourot, Jean Mariani, Philippe Faure
Anxiolytic drugs are widely used in the elderly, a population particularly sensitive to stress. Stress, aging and anxiolytics all affect low-frequency oscillations in the hippocampus and prefrontal cortex (PFC) independently, but the interactions between these factors remain unclear. Here, we compared the effects of stress (elevated platform, EP) and anxiolytics (diazepam, DZP) on extracellular field potentials (EFP) in the PFC, parietal cortex and hippocampus (dorsal and ventral parts) of adult (8 months) and aged (18 months) Wistar rats...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29029617/association-of-red-cell-distribution-width-with-all-cause-and-cardiovascular-specific-mortality-in-african-american-and-white-adults-a-prospective-cohort-study
#2
Salman M Tajuddin, Mike A Nalls, Alan B Zonderman, Michele K Evans
BACKGROUND: While the mortality rate is declining in the United States, the life expectancy gap among different population groups suggests a need to identify biomarkers to improve early identification of individuals at risk. Red cell distribution width (RDW), a measure of anisocytosis, is an emerging biomarker of chronic disease morbidity and mortality, particularly in the elderly. However, little is known about its association with mortality risk in younger adults. The objectives of this study were to investigate the association between RDW and overall and cause-specific mortality risk, and to identify novel determinants of RDW level...
October 13, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29026148/exclusive-and-combined-use-of-statins-and-aspirin-and-the-risk-of-pancreatic-cancer-a-case-control-study
#3
Livia Archibugi, Matteo Piciucchi, Serena Stigliano, Roberto Valente, Giulia Zerboni, Viola Barucca, Michele Milella, Patrick Maisonneuve, Gianfranco Delle Fave, Gabriele Capurso
Data on the association between aspirin and statin use and Pancreatic Ductal AdenoCarcinoma (PDAC) risk are conflicting. These drugs are often co-prescribed, but no studies evaluated the potential combined or confounding effect of the two at the same time. We aimed to investigate the association between aspirin and statin exclusive and combined use and PDAC occurrence. Data on environmental factors, family and medical history were screened in a case-control study. PDAC cases were matched to controls for age and gender...
October 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29022166/patient-views-about-polypharmacy-medication-review-clinics-run-by-clinical-pharmacists-in-gp-practices
#4
Rosie Snell, Tim Langran, Parastou Donyai
Background Polypharmacy can decrease medication adherence and increase the incidence of adverse drug reactions and drug-drug interactions, resulting in falls, hospitalisations and other complications especially in the elderly. Medication-related problems of polypharmacy can be prevented through patient-centred medication reviews but research in this area has been completed largely without examining patients' viewpoints. Objective The aim was to investigate patient views about a clinical pharmacist-led patient-centred polypharmacy medication review service completed within 17 English GP practices with those ≥ 75 years of age and prescribed ≥ 15 medications, during 415 consultations...
October 11, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29019063/statin-prescribing-in-the-elderly-special-considerations
#5
REVIEW
M Leya, N J Stone
PURPOSE OF REVIEW: Our aim was to examine the current evidence behind prescribing statins to individuals over 65 years of age with emphasis on those older than 75. Individuals over 75 years of age may often have multiple comorbidities and take many medications. Additionally, they are often underrepresented in randomized controlled trials (RCTs) of statins in older populations. While results of RCTs demonstrate the benefit of statin therapy in both primary and secondary prevention patients, clinicians must more carefully consider adverse effects and drug-drug interactions before prescribing statin therapy as well as determining the intensity in older individuals...
October 11, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28991653/comorbidities-of-lung-disease-in-the-elderly
#6
REVIEW
Nicola Scichilone
Comorbidities are common in elderly individuals with chronic respiratory diseases. They can affect disease manifestations and severity and can even impact management. Comorbidities can affect the treatment of the lung disease, particularly because of the interaction with the respiratory drugs. Thus, a multidimensional approach with multidisciplinary intervention is suggested for elderly respiratory patients, switching from a disease-oriented scheme to a dysfunction-oriented approach. Unfortunately, older individuals are often excluded from clinical trials because of advanced age and comorbidities...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28979861/treatment-of-dermatophytosis-in-elderly-children-and-pregnant-women
#7
REVIEW
Subuhi Kaul, Savita Yadav, Sunil Dogra
Dermatophytic infection of the skin and its appendages is a common occurrence. Though usually straightforward, treatment of dermatophytosis becomes notably challenging in certain population groups - pregnant women, children, and elderly. Treatment with topical azoles/allylamines alone is effective in limited cutaneous disease in all three groups. Terbinafine is the preferred oral agent in elderly population for treatment of extensive cutaneous disease and onychomycosis due to its lack of cardiac complications and lower propensity for drug interactions...
September 2017: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/28976386/-the-management-of-ventricular-arrhythmias-in-the-elderly-are-there-differences
#8
Muhammet Dural, Bülent Görenek
Sudden cardiac deaths (SCD) are most often caused by ventricular arrhythmias (VA). Among all cause mortality in the elderly, the rate of SCD due to VA is decreasing. The choice of antiarrhythmic drug in elderly patients is not different according to younger patients. Treatment goals, patient compliance, drug interaction risk, liver and kidney function should be considered in the selection of antiarrhythmic drugs. ICD implantation provides mortality reduction in the elderly when appropriate patient selection is made...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28976384/-infective-endocarditis-in-elderly-patients
#9
Serap Şimşek Yavuz
Infective endocarditis (IE) is a rare disease, but it is still associated with high mortality and elderly represent a growing proportion of patients with this disease. At the moment, more than one third of the IE patients is over 70 years old in developed countries. Although mean age of patients with endocarditis is still between 40 and 50 years old in our country, it is a fact that more elderly patients with IE will be seen in the coming years because of the prolongation of the life span and the increase in the proportion of the elderly...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28976381/-approach-to-heart-failure-in-the-elderly
#10
Dilek Yeşilbursa
The prevalence of heart failure increases with age. Several specific changes in cardiac structure and function are associated with cardiac ageing. Because of age-associated changes leading to diastolic dysfunction, heart failure with preserved ejection fraction is the most common form of heart failure in the elderly. The diagnosis of heart failure may be difficult to diagnose in elderly patients because of a lack of typical symptoms and physical findings. The elderly patients may respond differently to heart failure medications...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28976374/-polypharmacy-and-drug-interactions-in-elderly-patients
#11
Aytül Belgi Yıldırım, Ali Yaşar Kılınç
Although the definition of polypharmacy is not yet clear today, it is generally regarded as drug use more than the patient needs. Advanced age is the most important risk factor for polypharmacy. In addition, other risk factors are loss of current cognitive functions, low socioeconomic level and nursing care. It is seen in about 40% of people over 75 years of age worldwide, varying between countries of extreme poverty. Incorrect drug use, drug side effects and drug-drug interaction lead to unwanted hospitalizations...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28976373/-comorbidities-in-the-elderly-patient-with-cardiovascular-disease
#12
Mürsel Şahin, Merih Kutlu
Comorbid conditions are very common in elderly cardiovascular patients. Therefore, the management of comorbid patients has become an important health problem with the increasing elderly population. There are currently no recommendations in the treatment guidelines that are specific enough for comorbid conditions. In order to improve this patients quality of life holistic approach, good evaluation of risk-benefit ratio and possible drug interactions should be considered carefully.
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28974110/acetylcholinesterase-inhibitors-beneficial-effects-on-comorbidities-in-patients-with-alzheimer-s-disease
#13
Vinod Kaushik, Sarah Toombs Smith, Emmanuel Mikobi, Mukaila A Raji
Elderly patients with Alzheimer's disease (AD) and other dementias are at high risk of polypharmacy and excessive polypharmacy for common coexisting medical conditions. Polypharmacy increases the risk of drug-drug and drug-disease interactions in these patients who may not be able to communicate early symptoms of adverse drug events. Three acetylcholinesterase inhibitors (ACHEIs) have been approved for AD: donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). They are also used off-label for other causes of dementia such as Lewy body and vascular dementia...
January 1, 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/28972235/drug-prescription-including-interactions-with-anticancer-treatments-in-the-elderly-a-global-approach
#14
M-E Rougé Bugat, M Bourgouin, S Gérard, S Lozano, D Brechemier, P Cestac, C Cool, L Balardy
BACKGROUND: Consequences of inappropriate prescriptions and polymedication in patients suffering from cancer are beginning to be well documented. However, the methods used to evaluate these consequences are often discussed. Few studies evaluate the risk of interaction with anticancer drugs in elderly patients suffering from cancer. OBJECTIVES: To describe the prevalence (i) of polypharmacy, (ii) of potentially inappropriate drug prescriptions and (iii) of drug interactions involving anticancer treatments, using a multiple reference tools...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28948135/pharmacological-management-of-anxiety-disorders-in-the-elderly
#15
Elizabeth A Crocco, Sindy Jaramillo, Caroline Cruz-Ortiz, Katherine Camfield
Anxiety disorders are common in the elderly. Additionally, anxiety symptoms often accompany co-morbid psychiatric, medical, as well as neurodegenerative diseases in the older population. Anxiety in the elderly, often accompanied by depression, can lead to worsening physical, cognitive and functional impairments in this vulnerable population. Antidepressants are considered first line treatment. Both SSRIs and SNRIs are efficacious and well-tolerated in the elderly. Some SSRIs are strong inhibitors of the cytochrome P450 hepatic pathway whereas others have less potential for drug interaction...
March 2017: Current Treatment Options in Psychiatry
https://www.readbyqxmd.com/read/28929696/-clinical-analysis-of-cervus-and-cucumis-polypeptide-injection-based-on-real-world-hospital-information-system
#16
Shuai-Ling Sun, Yan-Ming Xie, Yuan-Yuan Li, Yin Zhang, Dan-Hui Yi, Yan Zhuang
To analyze the clinical application of Cervus and Cucumis Polypeptide injection in the real world, in order to define the characteristics of clinical drug use and correlation, and provide reference for risk management and further study for Cervus and Cucumis Polypeptide injection. Descriptive analysis and association rules analysis were performed on 37 721 cases using Cervus and Cucumis Polypeptide injection in 26 hospitals nationwide. Cervus and Cucumis Polypeptide injection were mostly adopted by patients aged between 45 and 64(39...
November 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28918484/drug-herb-interactions-in-the-elderly-patient-with-ibd-a-growing-concern
#17
REVIEW
Haider Rahman, Marina Kim, Galen Leung, Jesse A Green, Seymour Katz
Inflammatory bowel disease (IBD), which includes conditions such as Crohn's disease and ulcerative colitis, is becoming more prevalent with the elderly being the fastest growing group. Parallel to this, there is an increasing interest in the use of complementary and alternative medicine (CAM). Nearly half of patients with IBD have used CAM at one time. The elderly patients, however, are burdened by comorbid conditions, polypharmacy, and altered functional status. With increasing use of complementary and alternative medicine in our elderly patients with IBD, it is vital for the provider to provide counsel on drug-herb potential interactions...
September 16, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28916385/bacterial-pneumonia-in-older-adults
#18
REVIEW
Oryan Henig, Keith S Kaye
The incidence of pneumonia increases with age, and is particularly high in patients who reside in long-term care facilities (LTCFs). Mortality rates for pneumonia in older adults are high and have not decreased in the last decade. Atypical symptoms and exacerbation of underlying illnesses should trigger clinical suspicion of pneumonia. Risk factors for multidrug-resistant organisms are more common in older adults, particularly among LTCF residents, and should be considered when making empiric treatment decisions...
September 12, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28914077/decision-algorithms-for-direct-oral-anticoagulant-use-in-patients-with-nonvalvular-atrial-fibrillation-a-practical-guide-for-neurologists
#19
Isabella Canavero, Giuseppe Micieli, Maurizio Paciaroni
Direct oral anticoagulants (DOACs) are valid alternative options to vitamin K antagonists due to their limited interactions with drugs or food and the fact that they do not require regular coagulation monitoring. To this regard, recent practice guidelines recommend that DOACs should be considered as first-line anticoagulant therapy for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). This review (1) outlines current international guidelines for the management of DOACs to prevent stroke in patients with NVAF, (2) outlines indications for elderly patients as well as specific settings including acute coronary syndromes and intracranial hemorrhage, and (3) offers a practical guide for the use of DOACs in neurological settings...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28910830/consensus-guidelines-for-therapeutic-drug-monitoring-in-neuropsychopharmacology-update-2017
#20
C Hiemke, N Bergemann, H W Clement, A Conca, J Deckert, K Domschke, G Eckermann, K Egberts, M Gerlach, C Greiner, G Gründer, E Haen, U Havemann-Reinecke, G Hefner, R Helmer, G Janssen, E Jaquenoud, G Laux, T Messer, R Mössner, M J Müller, M Paulzen, B Pfuhlmann, P Riederer, A Saria, B Schoppek, G Schoretsanitis, M Schwarz, M Silva Gracia, B Stegmann, W Steimer, J C Stingl, M Uhr, S Ulrich, S Unterecker, R Waschgler, G Zernig, G Zurek, P Baumann
Therapeutic drug monitoring (TDM) is the quantification and interpretation of drug concentrations in blood to optimize pharmacotherapy. It considers the interindividual variability of pharmacokinetics and thus enables personalized pharmacotherapy. In psychiatry and neurology, patient populations that may particularly benefit from TDM are children and adolescents, pregnant women, elderly patients, individuals with intellectual disabilities, patients with substance abuse disorders, forensic psychiatric patients or patients with known or suspected pharmacokinetic abnormalities...
September 14, 2017: Pharmacopsychiatry
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