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Drug geriatrics

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https://www.readbyqxmd.com/read/28432019/feasibility-of-mini-tablets-as-a-flexible-drug-delivery-tool
#1
Biplob Mitra, Jessica Chang, Sy-Juen Wu, Chad N Wolfe, Robert L Ternik, Thomas Z Gunter, Michael C Victor
Mini-tablets have potential applications as a flexible drug delivery tool in addition to their generally perceived use as multi-particulates. That is, mini-tablets could provide flexibility in dose finding studies and/or allow for combination therapies in the clinic. Moreover, mini-tablets with well controlled quality attributes could be a prudent choice for administering solid dosage forms as a single unit or composite of multiple mini-tablets in patient populations with swallowing difficulties (e.g., pediatric and geriatric populations)...
April 18, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#2
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/28416161/cellular-senescence-a-translational-perspective
#3
REVIEW
James L Kirkland, Tamara Tchkonia
Cellular senescence entails essentially irreversible replicative arrest, apoptosis resistance, and frequently acquisition of a pro-inflammatory, tissue-destructive senescence-associated secretory phenotype (SASP). Senescent cells accumulate in various tissues with aging and at sites of pathogenesis in many chronic diseases and conditions. The SASP can contribute to senescence-related inflammation, metabolic dysregulation, stem cell dysfunction, aging phenotypes, chronic diseases, geriatric syndromes, and loss of resilience...
April 12, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28412926/acute-symptomatic-seizures-in-geriatric-patients-with-multiple-risk-factors-a-diagnostic-challenge
#4
Ralf Landwehr, Robert Liszka
Acute symptomatic seizures and epileptic disorders are frequent health problems of elderly patients. An early and reliable distinction of the seizure etiology is important to ensure adequate treatment, and to prevent unwarranted diagnostic and therapeutic procedures. The most common causes of acute symptomatic seizures - acute cerebrovascular disorders, metabolic disorders, traumatic brain injury, meningo-encephalitis, cerebral tumors, and withdrawal of alcohol and other central agents - are well-defined and seem to permit straightforward diagnostic and therapeutic strategies...
April 13, 2017: Current Aging Science
https://www.readbyqxmd.com/read/28391026/radiopharmaceuticals-in-the-elderly-cancer-patient-practical-considerations-with-a-focus-on-prostate-cancer-therapy-a-position-paper-from-the-international-society-of-geriatric-oncology-task-force
#5
John O Prior, Silke Gillessen, Manfred Wirth, William Dale, Matti Aapro, Wim J G Oyen
Molecular imaging using radiopharmaceuticals has a clear role in visualising the presence and extent of tumour at diagnosis and monitoring response to therapy. Such imaging provides prognostic and predictive information relevant to management, e.g. by quantifying active tumour mass using positron emission tomography/computed tomography (PET/CT). As these techniques require only pharmacologically inactive doses, age and potential frailty are generally not important. However, this may be different for therapy involving radionuclides because the radiation can impact normal bodily function (e...
April 6, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28387102/-how-i-treat-delirium-in-the-aged
#6
S Christelbach, J Petermans, S Allepaerts
Delirium is an acute psycho-organic disorder, most of the time reversible, that happens in various situations (acute disease, drugs ... ). It can also result from an acute or long term stress when the patient is already in an unstable homeostatic balance. Delirium is common in the geriatric population and can have serious consequences in terms of morbidity and mortality. Unfortunately, it is often not well known by hospital doctors. It is the consequence of predisposing factors (age, polypharmacy, multiple illnesses, neurodegenerative diseases, ...
November 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28386820/oral-teicoplanin-as-an-alternative-first-line-regimen-in-clostridium-difficile-infection-in-elderly-patients-a-case-series
#7
Benjamin Davido, Céline Leplay, Frédérique Bouchand, Aurélien Dinh, Maryvonne Villart, Jean-Laurent Le Quintrec, Laurent Teillet, Jérôme Salomon, Hugues Michelon
BACKGROUND: Elderly patients are more susceptible to Clostridium difficile infections (CDIs). Despite existing guidelines, there is no specific treatment for CDI in geriatrics. Vancomycin is commonly used in the treatment of CDI. Teicoplanin is an alternative glycopeptide which recently received marketing authorization approval for CDI in Europe. OBJECTIVES: Evaluate the potential interest of oral teicoplanin and assess whether such treatment could potentially become an alternative treatment in mild to severe CDIs in elderly patients...
April 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28376315/safety-and-efficacy-of-a-novel-drug-elores-ceftriaxone-sulbactam-disodium-edetate-in-the-management-of-multi-drug-resistant-bacterial-infections-in-tertiary-care-centers-a-post-marketing-surveillance-study
#8
Manu Chaudhary, Mohd Amin Mir, Shiekh Gazalla Ayub
OBJECTIVE: In India, elores (CSE-1034: ceftriaxone+sulbactam+disodium edetate) was approved as a broad spectrum antibiotic in year 2011 and is used for management of ESBL/MBL infections in tertiary care centers. The objective of this study was to investigate the efficacy of this drug in patients with ESBL/MBL infections and identify the incidence of adverse events in real clinical settings. METHODS: This PMS study was conducted at 17 centers across India and included 2500 patients of all age groups suffering from various bacterial infections and treated with CSE-1034...
April 1, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28372591/cooperation-between-geriatricians-and-general-practitioners-for-improved-pharmacotherapy-in-home-dwelling-elderly-people-receiving-polypharmacy-the-coop-study-study-protocol-for-a-cluster-randomised-controlled-trial
#9
Rita Romskaug, Espen Molden, Jørund Straand, Hege Kersten, Eva Skovlund, Kaisu H Pitkala, Torgeir Bruun Wyller
BACKGROUND: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various interventions for improving drug treatment have been evaluated, but the majority of studies are limited by the use of surrogate outcomes or suboptimal design. Thus, the potential for clinically significant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate the effect upon patient-relevant endpoints of a cooperation between geriatricians and general practitioners on complex drug regimens in home-dwelling elderly people...
April 4, 2017: Trials
https://www.readbyqxmd.com/read/28371121/clinical-medication-review-tool-for-polypharmacy-mapping-approach-for-pharmacotherapeutic-classifications
#10
Fumihiro Mizokami, Tomohiro Mizuno, Tomoyo Mori, Tadashi Nagamatsu, Hideharu Endo, Tomoyuki Hirashita, Takanobu Ichino, Masahiro Akishita, Katsunori Furuta
AIM: Polypharmacy is an extremely important problem, because it increases the risk of adverse drug reactions. The aim of the current study was to create a clinical medication review tool to detect inappropriate medication use, and assess this new method with elderly Japanese patients. METHODS: The new method involves optimizing prescription drugs from indications, based on the chronic disease-anatomical therapeutic class code list. The present study investigated the prevalence of potentially inappropriate medications in 5667 Japanese patients aged ≥65 years with polypharmacy (≥5 drugs) in comparison with the Beers criteria 2012...
March 30, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28368673/development-and-evaluation-of-orally-disintegrating-tablets-comprising-taste-masked-mirtazapine-granules
#11
Simay Yıldız, Eren Aytekin, Burçin Yavuz, Sibel Bozdağ Pehlivan, İmran Vural, Nurşen Ünlü
INTRODUCTION: Orally disintegrating tablets (ODTs) provide an important treatment option for pediatric, geriatric, and psychiatric patients. In our previous study, we have performed the initial studies for the formulation development and characterization of new ODT formulations containing a bitter taste drug, mirtazapine, coated with 6% (w/w) Eudragit® E-100 (first group of formulations, FGF) without taste evaluation. In present study, coating ratio of the drug was increased to 8% (w/w) (second group of formulations, SGF) to examine the effect of increased coating ratio of drug on in vitro characterization of the formulations including in vitro taste masking study...
April 3, 2017: Pharmaceutical Development and Technology
https://www.readbyqxmd.com/read/28364996/geriatric-polypharmacy-two-physicians-personal-perspectives
#12
REVIEW
Zhe Chen, Anthony Buonanno
Being a clinical provider in today's health care environment has become complex with more levels of care to negotiate. Who is caught in the middle of this complexity? Senior citizens. As we evolve into the new quality model, new problems and complexities occur. Numerous protocols and guidelines necessitate the initiation of drugs for given diagnoses and aggressive treatments. This article discusses geriatric polypharmacy from two practitioners' viewpoints: Zhe Chen, MD, discusses the point of view of a physician provider, and Anthony Buonanno, MD, discusses providers' roles in their own families...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28364991/polypharmacy-and-delirium-in-critically-ill-older-adults-recognition-and-prevention
#13
REVIEW
Erik Garpestad, John W Devlin
Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28359364/age-dependent-risk-factors-for-malnutrition-in-traumatology-and%C3%A2-orthopedic-patients
#14
Christine Lambert, Andreas Nüssler, Hans Konrad Biesalski, Thomas Freude, Christian Bahrs, Gunnar Ochs, Ingo Flesch, Ulrich Stöckle, Christoph Ihle
OBJECTIVE: The aim of this study was to investigate the prevalence of risk of malnutrition (RoM) in an orthopedic and traumatology patient cohort with a broad range of ages. In addition to the classical indicators for risk assessment (low body mass index, weight loss, and comorbidity), this study aimed to analyze the effects of lifestyle factors (eating pattern, smoking, physical activity) on RoM. METHODS: The prospective cohort study included 1053 patients in a level 1 trauma center in Germany...
May 2017: Nutrition
https://www.readbyqxmd.com/read/28358232/medical-parole-and-aging-prisoners
#15
George Pro, Miesha Marzell
The population of geriatric prisoners in the United States will reach unprecedented levels in the coming decades. Geriatric prisoners are at increased risk for deteriorating health and experience the onset of disease earlier than the aging population at large. Medical parole is an underutilized program that allows aging prisoners to transition to community-based health care. This article presents original key informant interview data and analysis of the perceptions of medical parole. Three dominant themes emerged: (1) drugs and nonviolent crimes; (2) politics, costs, and consequences; and (3) quality of health care and sense of security in prison...
January 1, 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28352631/guidance-on-opioids-prescribing-for-the-management-of-persistent-non-cancer-pain-in-older-adults
#16
REVIEW
Fabio Guerriero
Many older adults suffer from persistent pain but prevalence studies consistently showed high levels of untreated or under-treated pain in old population. Both persistent pain and pain under-treatment adversely affect independence and quality of life in geriatric patients. Pain management is challenging in this age-group because of the declining organ function, the presence of concurrent diseases and polypharmacy. For all the above reasons, persistent pain in the elderly should be considered a geriatric syndrome per se and effective approaches are warranted...
March 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28346565/anticholinergic-burden-and-functional-status-in-older-people-with-cognitive-impairment-results-from-the-regal-project
#17
V Boccardi, M Baroni, L Paolacci, S Ercolani, A Longo, M Giordano, C Ruggiero, P Mecocci
OBJECTIVE: The use of drugs with intrinsic anticholinergic properties is widespread among old age persons. A growing body of evidences suggest that a high anticholinergic burden is associated with physical and cognitive impairment. However, the association between anticholinergic drug use and functional status is still poorly investigated, particularly among subjects with initial cognitive impairment. DESIGN: Cross-sectional study examining the association between drug-related anticholinergic burden and functional status in cognitively healthy (CH) (n=691), mild cognitive impairment (MCI) (n=541) or mild Alzheimer's diseases (AD) (n=1127) subjects...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28334979/the-effectiveness-of-optimised-clinical-medication-reviews-for-geriatric-patients-opti-med-a-cluster-randomised-controlled-trial
#18
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background.: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective.: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28331326/lithium-in-late-life-mania-a-systematic-review
#19
REVIEW
Pasquale De Fazio, Raffaele Gaetano, Mariarita Caroleo, Maria Pavia, Giovanbattista De Sarro, Andrea Fagiolini, Cristina Segura-Garcia
The prevalence of mania among >65-year-olds ranges from 0.1% to 0.4% and its treatment is a particular challenge for clinicians. Although lithium is the treatment of choice for bipolar disorder (BD), its use in elderly population was recently questioned. This study provides a comprehensive review of literature on the efficacy and tolerability of lithium as a pharmacologic treatment for mania in elderly BD patients. We conducted a systematic review, based on PRISMA guidelines, of articles published between 1970 and August 2016 and indexed in the following databases: EMBASE, MEDLINE, Cochrane Library Databases and PsycINFO...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28322163/geriatric-oriented-high-dose-nutraceutical-odts-formulation-and-physicomechanical-characterization
#20
Ahmed M Agiba, Sameh Abdel-Hamid, Maha Nasr, Ahmed S Geneidi
CONTEXT: Oral disintegrating tablets (ODTs) represent a better option than conventional tablets for geriatric population, owing to their fast onset of action and their better patient compliance. OBJECTIVE: Two principal therapeutic high-dose nutraceuticals; chondroitin sulphate and glucosamine were formulated into an oral disintegration tablet (ODT) intended for sublingual administration, and optimized to improve compliance and achieve rapid onset of action in osteoarthritis treatment...
March 20, 2017: Current Drug Delivery
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