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Drug geriatrics

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https://www.readbyqxmd.com/read/28346565/anticholinergic-burden-and-functional-status-in-older-people-with-cognitive-impairment-results-from-the-regal-project
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28302515/orodispersible-films-towards-drug-delivery-in-special-populations
#5
REVIEW
Mariagiovanna Scarpa, Sven Stegemann, Wen-Kai Hsiao, Heinz Pichler, Simon Gaisford, Massimo Bresciani, Amrit Paudel, Mine Orlu
Orodispersible films (ODF) hold promise as a novel delivery method, with the potential to deliver tailored therapies to different patient populations. Together with the current trends and potential therapeutic areas such technology can address, some of the unmet needs in terms of quality aspects and manufacturing of conventional and novel (printed) ODF are discussed. Overall, this article aims to stimulate further research to fill the current knowledge gap between manufacturing and administration requirements of ODF targeting specific patient subpopulations such as geriatrics...
March 13, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28299634/prevalence-and-determinants-of-the-use-of-lipid-lowering-agents-in-a-population-of-older-hospitalized-patients-the-findings-from-the-reposi-registro-politerapie-societ%C3%A3-italiana-di-medicina-interna-study
#6
Marco Bertolotti, Carlotta Franchi, Marco B L Rocchi, Andrea Miceli, M Vittoria Libbra, Alessandro Nobili, Giulia Lancellotti, Lucia Carulli, Chiara Mussi
BACKGROUND: Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. AIM: The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. METHODS: We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28292582/-profile-and-evolution-of-chronic-complex-patients-in-a-subacute-unit
#7
Neus Gual, Anna Yuste Font, Belen Enfedaque Montes, Carles Blay Pueyo, Remedios Martín Álvarez, Marco Inzitari
OBJECTIVE: To improve the management of geriatric pluripathologic patients in Catalonia, the identification of chronic complex patient (PCC) or patients with advanced chronic disease (MACA) has been promoted. Patients with exacerbated chronic diseases are promoted to be admitted in subacute units (SG) located in intermediate hospitals and specialized in geriatric care, as an alternative to acute hospital. The results of the care process in patients identified as PCC/MACA in SG have not been evaluated...
March 11, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28292532/-intravenous-iron-functional-recovery-and-delirium-in-patients-with-hip-fracture-federef-study-single-centre-randomised-placebo-controlled-and-double-blind-clinical-trial-2014-001923-53-eudract-number
#8
Rafael Bielza Galindo, Jesús Llorente Gutiérrez, José Luis Pérez González, Asunción Mora Casado, David Blanco Díaz, Javier Escalera Alonso, Adoración Morales Fernández, Cristina Molano Ortiz, Beredys Esmirla García López, Nazaret Del Amo Del Arco, Juan Pablo Barro Ordovas, Estefanía Arias Muñana, Marta Neira Álvarez, David Sanz Rosa, Jorge Fco Gómez Cerezo
INTRODUCTION: There are no previous studies evaluating the effect of intravenous iron therapy on functional and cognitive status of patients with hip fracture (HF). MATERIAL AND METHODS: A single-centre randomised, placebo-controlled, double-blind and parallel treatment, clinical trial has been designed to assess the efficacy of intravenous iron therapy during the peri-operative period in elderly patients suffering from a HF. Blinding will be ensured by the packaging of the drug infusion system...
March 11, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28290728/diffuse-large-b-cell-lymphoma-in-the-elderly-standard-treatment-and-new-perspectives
#9
Chiappella Annalisa, Alessia Castellino, Maura Nicolosi, Elisa Santambrogio, Umberto Vitolo
Diffuse large B-cell lymphoma (DLBCL) is the most common histotype in non Hodgkin lymphoma, with a peak incidence in the sixth decade. The standard treatment for elderly FIT DLBCL patients is Rituximab-CHOP; in unfit and frail patients, chemotherapy at reduced intensity should be considered. Areas covered: In this article, we will review use of standard therapies and new drugs investigated such as immonomudulating agents (IMiDs), Bruton Tyrosine Kinase (BTK), in fit, unfit, frail and very elderly DLCBL patients...
March 14, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28286660/preference-of-elderly-patients-to-oral-or-intravenous-chemotherapy-in-heavily-pre-treated-recurrent-ovarian-cancer-final-results-of-a-prospective-multicenter-trial
#10
Radoslav Chekerov, Philipp Harter, Stefan Fuxius, Lars Christian Hanker, Linn Woelber, Lothar Müller, Peter Klare, Wolfgang Abenhardt, Yoana Nedkova, Isil Yalcinkaya, Georg Heinrich, Harald Sommer, Sven Mahner, Pauline Wimberger, Dominique Koensgen-Mustea, Rolf Richter, Gülten Oskay-Oezcelik, Jalid Sehouli
BACKGROUND: Palliative systemic treatment in elderly gynaecological cancer patients remains a major challenge. In recurrent ovarian cancer (ROC), treosulfan an active alkylating drug showed similar cytotoxicity whether as oral (p.o.) or intravenous (i.v.) application. The aim of this innovative trial was to evaluate the preference of elderly patients (≥65 years) for p.o. or i.v. chemotherapy focusing compliance, outcome, toxicities, and geriatric aspects as secondary endpoints. METHODS: Patients with ROC had the free choice between treosulfan i...
2017: Gynecologic Oncology Research and Practice
https://www.readbyqxmd.com/read/28276131/different-clinical-effect-of-four-antidementia-drugs-for-alzheimer-s-disease-patients-depending-on-white-matter-severity
#11
Yusuke Fukui, Nozomi Hishikawa, Jin Ichinose, Kota Sato, Yumiko Nakano, Ryuta Morihara, Yasuyuki Ohta, Toru Yamashita, Koji Abe
AIM: To examine the clinical effect of four antidementia drugs (donepezil, galantamine, rivastigmine and memantine) in Alzheimer's disease patients who were divided into subgroups based on their periventricular hyperintensity (PVH) severity. METHODS: A total of 551 Alzheimer's disease patients (201 men and 350 women) were divided into four subgroups based on their PVH severity (0-III). They received monotherapy for 12 months. We compared the clinical effects at the baseline, and at 3, 6 and 12 months after initiation...
March 9, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28270270/a-review-of-suvorexant-doxepin-ramelteon-and-tasimelteon-for-the-treatment-of-insomnia-in-geriatric-patients
#12
Chelsey Edmonds, Michael Swanoski
Geriatric patients often experience insomnia because of physiological and neurological changes that occur during the aging process. Use of benzodiazepines, nonbenzodiazepine hypnotics, and diphenhydramine for the treatment of insomnia pose an increased risk of cognitive impairment, falls, and fractures in this patient population. Therapeutic alternatives approved by the Food and Drug Administration include suvorexant, doxepin, ramelteon, and tasimelteon, which have shown efficacy and safety in various studies...
March 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28259059/evaluation-of-medication-related-clinical-decision-support-alert-overrides-in-the-intensive-care-unit
#13
Adrian Wong, Mary G Amato, Diane L Seger, Sarah P Slight, Patrick E Beeler, Patricia C Dykes, Julie M Fiskio, Elizabeth R Silvers, E John Orav, Tewodros Eguale, David W Bates
PURPOSE: Medication-related clinical decision support (CDS) has been identified as a method to improve patient outcomes but is historically frequently overridden and may be inappropriately so. Patients in the intensive care unit (ICU) are at a higher risk of harm from adverse drug events (ADEs) and these overrides may increase patient harm. The objective of this study is to determine appropriateness of overridden medication-related CDS overrides in the ICU. MATERIALS AND METHODS: We evaluated overridden medication-related alerts of four alert categories from January 2009 to December 2011...
February 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28258537/use-of-an-e-learning-educational-module-to-better-equip-doctors-to-prescribe-for-older-patients-a-randomised-controlled-trial
#14
Shane Cullinan, Denis O'Mahony, Stephen Byrne
BACKGROUND: The older patient population is significantly different from the younger adult population with regards to dose selection for a wide variety of drugs. Recent investigation of prescribing attitudes indicates that doctors feel there is insufficient distinction made between the two cohorts during their undergraduate education, and that doctors do not receive enough training in geriatric pharmacotherapy. OBJECTIVES: The aim of this study was to determine if an online module, focused on geriatric pharmacotherapy, improves doctors' prescribing knowledge, as well as prescribing confidence, as applied to older patients...
March 4, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28258036/use-of-ace-inhibitors-and-falls-in-patients-with-parkinson-s-disease
#15
Alice Laudisio, Maria Rita Lo Monaco, Maria Caterina Silveri, Anna Rita Bentivoglio, Davide L Vetrano, Maria Stella Pisciotta, Vincenzo Brandi, Roberto Bernabei, Giuseppe Zuccalà
Falls represent a major concern in patients with Parkinson's disease (PD); however, currently acknowledged treatments for PD are not effective in reducing the risk of falling. The aim was to assess the association of use of ACE-inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) with falls among patients with PD. We analysed data of 194 elderly with PD attending a geriatric Day Hospital. Self-reported history of falls that occurred over the last year, as well as use of drugs, including ACEIs and angiotensin II receptor blockers (ARBs) were recorded...
February 22, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28256432/phase-ii-study-of-dose-attenuated-bortezomib-cyclophosphamide-and-dexamethasone-vcd-lite-in-very-old-or-otherwise-toxicity-vulnerable-adults-with-newly-diagnosed-multiple-myeloma
#16
Sascha A Tuchman, Joseph O Moore, Carlos D DeCastro, Zhiguo Li, Emily Sellars, Yubin Kang, Gwynn Long, Cristina G Gasparetto
OBJECTIVES: Multiple myeloma (MM) primarily strikes older adults, but full-dose chemotherapy such as bortezomib (Velcade), cyclophosphamide and dexamethasone (VCD) is often excessively toxic to very old or frail adults and those with substantial comorbidities. We piloted dose-attenuated VCD ("VCD-Lite") in such vulnerable adults with newly diagnosed MM (NDMM). MATERIALS AND METHODS: Subjects with NDMM and a high risk of therapy-related toxicity due to factors above received bortezomib 1...
February 27, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28244024/-geriatric-inpatients-with-iron-deficiency-associated-restless-legs-syndrome-a-retrospective-analysis
#17
Benjamin Lieske, Gabriele Röhrig, Ingrid Becker, Ralf-Joachim Schulz, Maria Cristina Polidori, Jan Kassubek
OBJECTIVE: The Restless Legs Syndrome (RLS) is a clinically relevant condition in geriatric patients. An association between iron deficiency and RLS is largely acknowledged. The clinical and therapeutic management of iron deficiency-associated RLS has been, however, poorly evaluated in geriatric patients. METHODS: Data from all RLS inpatients admitted to a geriatric unit between 2009 and 2011 were retrospectively collected on demographics and clinical characteristics, iron status, drug treatment including iron substitution, as well as comprehensive geriatric assessment (CGA) scores...
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28229530/an-audit-of-anticholinergic-medication-changes-in-older-hospitalised-patients-using-the-anticholinergic-drug-scale
#18
Michele Lee, Hugh Carl Hanger
OBJECTIVE: In patients discharged from an Older Person's Health hospital, we assessed 1) the prevalence of anticholinergic medications in this study population and 2) changes in anticholinergic drug burden during admission using the Anticholinergic Drug Scale (ADS). METHODS: Cases were identified between September 2010 and January 2011 using discharge coding data. Clinical notes were reviewed to determine which regular oral medications were commenced, altered or ceased during admission with their respective ADS level...
February 23, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28224957/-medicines-and-elderly-patients-abuse-dependency-or-attraction
#19
Pascal Menecier, Laure Menecier-Ossia
Psychotropic medicines represent, after alcohol, the second class of substances most susceptible to abuse by elderly people. It can be particularly difficult for caregivers to understand such behaviour as these are prescription-only medicines. This misuse is partly a result of older people tending to trivialise and overrate pharmaceutical drugs, ignoring the potential of non-medicinal methods and psychotherapeutic treatments. The boundaries between prescribed use, overuse, self-medication, excessive use, dependency or addiction to prescription drugs are blurred in older people...
January 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28224699/comparison-of-four-criteria-for-potentially-inappropriate-medications-in-brazilian-community-dwelling-older-adults
#20
Priscila Horta Novaes, Danielle Teles da Cruz, Alessandra Lamas Granero Lucchetti, Isabel Cristina Gonçalves Leite, Giancarlo Lucchetti
AIM: To compare four potentially inappropriate medication (PIM) criteria from different regions of the world in terms of their characteristics, concordance, sensitivity, specificity and predictive values in a community-dwelling sample. METHODS: A cross-sectional, observational, epidemiological study was carried out by a door-to-door survey in a Brazilian city. The following PIM criteria were applied: Beers-2015, Screening Tool of Older People's Potentially Inappropriate Prescriptions (STOPP)-2015, The European Union (EU)(7)-PIM list and Taiwan criteria...
February 22, 2017: Geriatrics & Gerontology International
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