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Drug interactions in the elderly

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https://www.readbyqxmd.com/read/29210840/conoscere-e-curare-il-cuore-1986-2016-how-the-heart-has-changed
#1
Alessandro Boccanelli
: The demographic transition, with longer life expectancy, is mainly due to prevention and care of atherosclerotic vascular and heart disease. The cardiovascular patient is now much older and often presents with coexisting geriatric syndromes that affect healthcare goals, outcomes, and the process of care. Numerous mechanisms at cellular level are responsible for cardiovascular aging such as replicative senescence, apoptosis, proteins misfolding, and inflammation. Aging-related modifications are increase in left-ventricular mass, increased left atrial size, myocardial collagen deposition, and calcium deposition in valvular structures and the coronary arteries...
November 27, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29209239/genetic-biomarkers-on-age-related-cognitive-decline
#2
REVIEW
Chieh-Hsin Lin, Eugene Lin, Hsien-Yuan Lane
With ever-increasing elder populations, age-related cognitive decline, which is characterized as a gradual decline in cognitive capacity in the aging process, has turned out to be a mammoth public health concern. Since genetic information has become increasingly important to explore the biological mechanisms of cognitive decline, the search for genetic biomarkers of cognitive aging has received much attention. There is growing evidence that single-nucleotide polymorphisms (SNPs) within the ADAMTS9, BDNF, CASS4, COMT, CR1, DNMT3A, DTNBP1, REST, SRR, TOMM40, circadian clock, and Alzheimer's diseases-associated genes may contribute to susceptibility to cognitive aging...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29199172/when-proton-pump-inhibitors-are-compared-are-there-specific-cases-in-which-a-certain-proton-pump-inhibitors-should-be-particularly-preferred
#3
Altay Çelebi, Hasan Yılmaz
Currently, proton pump inhibitors (PPIs) are widely used either over the counter or on prescription drugs. PPI's are frequently used with other drugs when elderly and chronic desease burden population is taken to consideration. Drug interactions with PPIs are a prominent clinical problem in this direction. In this study, we reviewed potential risks of concomittant use of PPIs and other drugs and apropriate PPI choise.
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29198061/development-and-pilot-testing-of-pharao-a-decision-support-system-for-pharmacological-risk-assessment-in-the-elderly
#4
Ylva Böttiger, Kari Laine, Tuomas Korhonen, Janne Lähdesmäki, Tero Shemeikka, Margaretha Julander, Maria Edlert, Marine L Andersson
PURPOSE: The aims of this study are to describe the development of PHARAO (Pharmacological Risk Assessment Online), a decision support system providing a risk profile for adverse events, associated with combined effects of multiple medicines, and to present data from a pilot study, testing the use, functionality, and acceptance of the PHARAO system in a clinical setting. METHODS: About 1400 substances were scored in relation to their risk to cause any of nine common and/or serious adverse effects...
December 2, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29191263/persistent-and-severe-hypoglycemia-associated-with-trimethoprim-sulfamethoxazole-in-a-frail-diabetic-man-on-polypharmacy-a-case-report-and-literature-review%C3%A2
#5
Raffaella Rossio, Sara Arcudi, Flora Peyvandi, Stefania Piconi
OBJECTIVE: Trimethoprim-sulfamethoxazole (co-trimoxazole) is a commonly used broad-spectrum antibiotic, but it can be associated with potentially serious adverse effects, often not recognized by clinicians. This is a relevant problem in elderly patients, who are particularly susceptible to adverse drug reactions. Moreover, multiple medications taken by older people increase the risk for adverse drug reactions and drug-drug interactions. CASE REPORT: We report the case of an 85-year-old man with diabetes mellitus who attended the emergency room with severe hypoglycemia that persisted despite multiple intravenous bolus doses and continuous infusion of glucose...
November 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29175562/utilisation-and-polypharmacy-aspects-of-antiepileptic-drugs-in-elderly-versus-younger-patients-with-epilepsy-a-pharmacoepidemiological-study-of-cns-active-drugs-in-norway-2004-2015
#6
Arton Baftiu, Silje Andrea Feet, Pål Gunnar Larsson, Margrete Larsen Burns, Oliver Henning, Erik Sætre, Espen Molden, Anne Gerd Granas, Svein I Johannessen, Cecilie Johannessen Landmark
BACKGROUND AND PURPOSE: Many patients with epilepsy use antiepileptic drugs (AEDs) in combination. The elderly is a vulnerable group regarding polypharmacy. The purpose of this study was to investigate changes in utilisation of AEDs, and the extent of polypharmacy with other CNS-active drugs in elderly versus younger patients in Norway. METHODS: This pharmacoepidemiological study included all prescriptions of antiepileptic, antidepressant and antipsychotic drugs from Norwegian pharmacies in the Norwegian Prescription Database (NorPD) (2004-2015)...
November 11, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29125269/direct-oral-anticoagulants-use-in-elderly-patients-with-non-valvular-atrial-fibrillation-state-of-evidence
#7
Giulia Benedetti, Matteo Neccia, Luciano Agati
Non-valvular atrial fibrillation (NVAF) increases the risk of stroke by three- to five-fold, especially in elderly patients, creating a huge burden on medical system as well as a negative impact on patients lives. Balancing efficacy and bleeding risk is a challenge when considering anticoagulation therapy in elderly patients, because of their frequent high risk of both stroke and bleeding. Real world data reveal the underuse of anticoagulation in the elderly, especially due to physicians' fear of bleeding, often neglecting the thromboembolic risk...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29089750/inappropriate-pharmacological-treatment-in-older-adults-affected-by-cardiovascular-disease-and-other-chronic-comorbidities-a-systematic-literature-review-to-identify-potentially-inappropriate-prescription-indicators
#8
Ersilia Lucenteforte, Niccolò Lombardi, Davide Liborio Vetrano, Domenico La Carpia, Zuzana Mitrova, Ursula Kirchmayer, Giovanni Corrao, Francesco Lapi, Alessandro Mugelli, Alfredo Vannacci
Avoiding medications in which the risks outweigh the benefits in the elderly patient is a challenge for physicians, and different criteria to identify inappropriate prescription (IP) exist to aid prescribers. Definition of IP indicators in the Italian geriatric population affected by cardiovascular disease and chronic comorbidities could be extremely useful for prescribers and could offer advantages from a public health perspective. The purpose of the present study was to identify IP indicators by means of a systematic literature review coupled with consensus criteria...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29073753/lithium-intoxication-a-possible-interaction-with-moxifloxacin
#9
Selvi Kayipmaz, Ali Ercan Altınöz, Nadide Elmas Gülcü Ok
Lithium is a well-known treatment for patients with mood disorders. Intoxication by lithium may be lethal particularly in elderly due to altered pharmacokinetics, renal impairment or multiple drug use. We presented a 74-year-old female patient who had been stabile with lithium carbonate 600 mg/day for 5 years and developed lithium intoxication after bronchiolitis. She presented with altered mental status. The neurological signs resolved slowly after lithium and moxifloxacin were stopped immediately and fluid resuscitation administered...
November 30, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29066862/localized-neuropathic-pain-an-expert-consensus-on-local-treatments
#10
REVIEW
Gisèle Pickering, Elodie Martin, Florence Tiberghien, Claire Delorme, Gérard Mick
BACKGROUND: Pain localization is one of the hallmarks for the choice of first-line treatment in neuropathic pain. This literature review has been conducted to provide an overview of the current knowledge regarding the etiology and pathophysiology of localized neuropathic pain (LNP), its assessment and the existing topical pharmacological treatments. MATERIALS AND METHODS: Literature review was performed using Medline from 2010 to December 2016, and all studies involving LNP and treatments were examined...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29058944/statin-drug-interactions-and-related-adverse-reactions-an-update
#11
Stefano Bellosta, Alberto Corsini
Statins reduce the risk of cardiovascular morbidity and mortality in patients with or at risk for cardiovascular disease and their use is expanding, especially in elderly. Statins are prescribed on a long-term basis and may undergo drug-drug interactions (DDIs) with other drugs. Statins have different safety and tolerability, and this might affect the possibility of DDIs with other cardiovascular drugs, increasing the risk of statin-associated myopathy and hepatotoxicity. Polypharmacy and pharmacogenetic variability are potential causes of statin DDIs...
October 30, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29033825/acute-stress-affects-the-expression-of-hippocampal-mu-oscillations-in-an-age-dependent-manner
#12
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
#13
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
#14
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
#15
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...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29019063/statin-prescribing-in-the-elderly-special-considerations
#16
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
#17
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
#18
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
#19
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
#20
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
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