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Drug geriatrics

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https://www.readbyqxmd.com/read/27921436/-diabetes-mellitus-in-older-adults-from-the-point-of-view-of-the-clinical-diabetologist
#1
Alena Šmahelová
Disorders of glucose homeostasis affect quite a large part of the older population and their incidence including manifest diabetes is growing. Diabetes in older adults is associated with an increased risk of geriatric syndrome expressed in various ways (decrease in muscle size, functional disability, frailty) and early mortality. Diabetes care for the elderly requires, also in view of heterogeneity of diabetes itself, an individual specific approach. This involves not only diagnostics and a clinical picture, but also the treatment goals and the therapy of diabetes and complications in itself...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27921260/development-of-oral-flexible-tablet-oft-formulation-for-pediatric-and-geriatric-patients-a-novel-age-appropriate-formulation-platform
#2
Prabagaran Chandrasekaran, Ruckmani Kandasamy
Development of palatable formulations for pediatric and geriatric patients involves various challenges. However, an innovative development with beneficial characteristics of marketed formulations in a single formulation platform was attempted. The goal of this research was to develop solid oral flexible tablets (OFTs) as a platform for pediatrics and geriatrics as oral delivery is the most convenient and widely used mode of drug administration. For this purpose, a flexible tablet formulation using cetirizine hydrochloride as model stability labile class 1 and 3 drug as per the Biopharmaceutical Classification System was developed...
December 5, 2016: AAPS PharmSciTech
https://www.readbyqxmd.com/read/27915457/combined-use-of-the-rationalization-of-home-medication-by-an-adjusted-stopp-in-older-patients-rasp-list-and-a-pharmacist-led-medication-review-in-very-old-inpatients-impact-on-quality-of-prescribing-and-clinical-outcome
#3
Lorenz Van der Linden, Liesbeth Decoutere, Karolien Walgraeve, Koen Milisen, Johan Flamaing, Isabel Spriet, Jos Tournoy
BACKGROUND: Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. OBJECTIVES: Our objective was to evaluate the effect of a pharmacist intervention, consisting of the application of the Rationalization of home medication by an Adjusted STOPP in older Patients (RASP) list and a pharmacist-led medication review on polypharmacy, the quality of prescribing, and clinical outcome in geriatric inpatients...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27908273/pharmacokinetic-and-pharmacodynamic-features-of-nanoemulsion-following-oral-intravenous-topical-and-nasal-route
#4
Hira Choudhury, Bapi Gorain, Bappaditya Chatterjee, Uttam Kumar Mandal, Pinaki Sengupta, Rakesh Kumar Tekade
Most of the active pharmaceutical ingredients discovered recently in pharmaceutical field exhibits poor aqueous solubility that pose major problem in their oral administration. The oral administration of these drugs gets further complicated due to their short bioavailability, inconsistent absorption and inter/intra subject variability. Pharmaceutical emulsion holds a significant place as a primary choice of oral drug delivery system for lipophilic drugs used in pediatric and geriatric patients. Pharmacokinetic studies on nanoemulsion mediated drugs delivery approach indicates practical feasibility in regards to their clinical translation and commercialization...
December 1, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27901275/peripheral-nerve-blocks-for-the-treatment-of-headache-in-older-adults-a-retrospective-study
#5
Jacob R Hascalovici, Matthew S Robbins
OBJECTIVE: The objective of this study is to provide demographical and clinical descriptions of patients age 65 years old and older who were treated with peripheral nerve blocks (PNBs) at our institution and evaluate the safety and efficacy of this treatment. BACKGROUND: Headache disorders are common, disabling chronic neurological diseases that often persist with advancing age. Geriatric headache management poses unique therapeutic challenges because of considerations of comorbidity, drug interactions, and adverse effects...
November 30, 2016: Headache
https://www.readbyqxmd.com/read/27891571/high-risk-medications-in-hospitalized-elderly-adults-are-we-making-it-easy-to-do-the-wrong-thing
#6
Nina L Blachman, Rosanne M Leipzig, Madhu Mazumdar, Jashvant Poeran
OBJECTIVES: To examine dosages of high-risk medications administered to elderly adults who fall in the hospital and to determine whether electronic default doses are appropriate for elderly adults. DESIGN: Retrospective. SETTING: Large urban academic hospital. PARTICIPANTS: Individuals aged 65 and older experiencing a fall. MEASUREMENTS: Prescribed daily dosages and use of high-risk medications (opiates, benzodiazepines, benzodiazepine-receptor agonists (BRAs), sleep medications, muscle relaxants, antipsychotics) administered within 24 hours before a fall were ascertained and compared with published recommended dosages for older adults and the hospital's electronic medical record (EMR) default doses for these drugs...
November 28, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27891399/effect-of-citalopram-in-combination-with-omega-3-on-depression-in-post-menopausal-women-a-triple-blind-randomized-controlled-trial
#7
Seyedeh Zahra Masoumi, Farideh Kazemi, Samira Tavakolian, Alireza Rahimi, Khodayar Oshvandi, Alireza Soltanian, Fatemeh Shobeiri
INTRODUCTION: Depressive disorder is a common and disabling disorder that causes high rates of morbidity and mortality. Citalopram is an antidepressant drug, of the Selective Serotonin Reuptake Inhibitor (SSRI) class that has been used for geriatric depression since a long time ago. Prescription of omega-3 in geriatric depression has been increased recently; because of more favorable profile of their side effects. Some of the studies reported that omega-3 is effective in prevention or treatment of depressive disorders than Citalopram...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27886691/pharmacotherapy-pearls-for-the-geriatrician-focus-on-oral-disease-modifying-antirheumatic-drugs-including-newer-agents
#8
REVIEW
Ann J Biehl, James D Katz
Providing safe and effective pharmacotherapy to the geriatric patients with rheumatological disorders is an ongoing struggle for the rheumatologist and geriatrician alike. Cohesive communication and partnership can improve the care of these patients and subvert adverse outcomes. Disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the newest oral agent for treatment of rheumatoid arthritis, tofacitinib, have distinctive monitoring and adverse effect profiles...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27885227/the-experience-of-dissolving-polypharmacy-by-reducing-the-prescription-of-anti-ulcer-drugs-in-residents-of-a-special-geriatric-nursing-home
#9
Kosuke Okada, Yumiko Yamaguch, Nanao Kamada, Masahiro Okada, Shigeko Katoh, Hidemi Sasaki
AIM: As part of a broader study on polypharmacy among elderly nursing home residents, we examined the impact of reducing or discontinuing the prescription of proton pump inhibitors and other anti-ulcer drugs. METHODS: We employed a strategy of reducing and discontinuing the prescription of drugs to 160 elderly residents of the Hiroshima Atomic Bomb survivors nursing home, Kandayama Yasuragien. The residents had entered the home between April 2012 and November 2015...
2016: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/27868320/predictors-of-rehospitalization-among-older-adults-results-of-the-crime-study
#10
Federica Sganga, Francesco Landi, Stefano Volpato, Antonio Cherubini, Carmelinda Ruggiero, Andrea Corsonello, Paolo Fabbietti, Fabrizia Lattanzio, Ester Manes Gravina, Roberto Bernabei, Graziano Onder
AIM: To assess the predictors of readmission among older adults hospitalized in acute care wards. METHODS: A prospective cohort study was carried out among 921 hospitalized older adults participating in the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project. The primary outcome of the study was rehospitalization within 1 year after discharge from acute care hospitals. We assessed the participants with a questionnaire including 350 items about demographic, social and clinical characteristics...
November 21, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27864240/new-horizons-in-orthostatic-hypotension
#11
REVIEW
James Frith, Steve W Parry
BACKGROUND: orthostatic hypotension (OH) is a common disabling condition associated with increased morbidity and mortality. Much of the evidence available is derived from younger populations with chronic neurological disease leading to uncertainty for the diagnosis and management of older people. OBJECTIVE: to provide an overview of recent and emerging evidence for the diagnosis, management and prognosis of OH in older persons. METHODS: a narrative review of recent studies, emerging therapies and relevant regulatory updates...
November 17, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27825595/effect-of-a-national-4c-antibiotic-stewardship-intervention-on-the-clinical-and-molecular-epidemiology-of-clostridium-difficile-infections-in-a-region-of-scotland-a-non-linear-time-series-analysis
#12
Timothy Lawes, José-María Lopez-Lozano, Cesar A Nebot, Gillian Macartney, Rashmi Subbarao-Sharma, Karen D Wares, Carolyn Sinclair, Ian M Gould
BACKGROUND: Whereas many antibiotics increase risk of Clostridium difficile infection through dysbiosis, epidemic C difficile ribotypes characterised by multidrug resistance might depend on antibiotic selection pressures arising from population use of specific drugs. We examined the effect of a national antibiotic stewardship intervention limiting the use of 4C antibiotics (fluoroquinolones, clindamycin, co-amoxiclav, and cephalosporins) and other infection prevention and control strategies on the clinical and molecular epidemiology of C difficile infections in northeast Scotland...
November 4, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27812813/-coagulation-management-in-geriatric-surgery
#13
H Eichler
BACKGROUND: Elderly patients often suffer from cardiovascular diseases and are treated with anticoagulation medications, which must be taken into consideration when planning elective surgery. OBJECTIVE: The etiology, diagnostic work-up and clinical management of selected inherited and acquired hemophilic and thrombophilic coagulation disorders are described. METHODS: Data from clinical studies, current guidelines and expert opinions are discussed...
November 3, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27807447/endoscopic-management-of-foreign-bodies-in-the-gastrointestinal-tract-a-review-of-the-literature
#14
REVIEW
Mikhael Bekkerman, Amit H Sachdev, Javier Andrade, Yitzhak Twersky, Shahzad Iqbal
Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world. Distinct foreign bodies predispose to particular locations of impaction in the gastrointestinal tract, commonly meat boluses in the esophagus above a preexisting esophageal stricture or ring in adults and coins in children. Several other groups are at high risk of foreign body impaction, mentally handicapped individuals or those with psychiatric illness, abusers of drugs or alcohol, and the geriatric population...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27803007/management-of-chronic-lymphocytic-leukemia-cll-in-the-elderly-a-position-paper-from-an-international-society-of-geriatric-oncology-siog-task-force
#15
REVIEW
R Stauder, B Eichhorst, M Hamaker, K Kaplanov, V Morrison, A Österborg, I Poddubnaya, J A Woyach, T Shanafelt, L Smolej, L Ysebaert, V Goede
Chronic lymphocytic leukemia (CLL) mainly affects older people: the median age at diagnosis is above seventy years. Elderly patients with CLL are heterogeneous with regard both to the biology of their disease and aging. Following the diagnosis of CLL in an elderly individual, careful risk assessment is essential when treatment options are evaluated. This includes not only clinical staging and evaluation of disease-specific prognostic biomarkers such as 17p deletion and TP53 mutation, but also of comorbidities, physical capacity, nutritional status, cognitive capacity, ability to perform activities of daily living, and social support...
November 1, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27790242/the-effects-of-donepezil-on-15-item-geriatric-depression-scale-structure-in-patients-with-alzheimer-disease
#16
Youngsoon Yang, Yong Tae Kwak
BACKGROUND/AIMS: In Alzheimer disease (AD), depression is among the most common accompanying neuropsychiatric symptoms and has different clinical manifestations when compared with early-life depression. In patients with drug-naïve AD, we tried to explore the structure of the 15-item Geriatric Depression Scale (GDS15) and the effect of donepezil on these substructures. METHODS: GDS15, cognitive function, and activities of daily living function tests were administered to 412 patients with probable AD who had not been medicated before visiting the hospital...
September 2016: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/27789367/development-of-a-novel-oral-delivery-system-of-edaravone-for-enhancing-bioavailability
#17
Ankit Parikh, Krishna Kathawala, Chun Chuan Tan, Sanjay Garg, Xin-Fu Zhou
Edaravone (EDR), a strong free radical scavenger, is known for its promising therapeutic potential in oxidative stress (OS) associated diseases, however poor oral bioavailability is the major obstacle in its potential use. Oral liquid dosage form is the most preferred delivery method in paediatric, geriatric and specialised therapies. The present research discusses the development of a Novel Oral Delivery System (NODS) of EDR to enhance oral bioavailability. From preformulation study, solubility, and stability were identified as key challenges and the requirement of an acidic environment and protection against oxidation were found to be critical...
October 24, 2016: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/27761112/hospitalizations-due-to-adverse-drug-events-in-the-elderly-a-retrospective-register-study
#18
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/27752225/orally-disintegrating-films-a-modern-expansion-in-drug-delivery-system
#19
Muhammad Irfan, Sumeira Rabel, Quratulain Bukhtar, Muhammad Imran Qadir, Farhat Jabeen, Ahmed Khan
Over the past few decades, tendency toward innovative drug delivery systems has majorly increased attempts to ensure efficacy, safety and patient acceptability. As discovery and development of new chemical agents is a complex, expensive and time consuming process, so recent trends are shifting toward designing and developing innovative drug delivery systems for existing drugs. Out of those, drug delivery system being very eminent among pediatrics and geriatrics is orally disintegrating films (ODFs). These fast disintegrating films have superiority over fast disintegrating tablets as the latter are associated with the risks of choking and friability...
September 2016: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/27751669/review-of-safety-and-efficacy-of-sleep-medicines-in-older-adults
#20
REVIEW
Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
November 2016: Clinical Therapeutics
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