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Drug geriatrics

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https://www.readbyqxmd.com/read/28550459/patterns-of-drug-prescriptions-in-an-orthogeriatric-ward-as-compared-to-orthopaedic-ward-results-from-the-trondheim-hip-fracture-trial-a-randomised-clinical-trial
#1
Marianne Heltne, Ingvild Saltvedt, Stian Lydersen, Anders Prestmo, Olav Sletvold, Olav Spigset
PURPOSE: In the Trondheim Hip Fracture Trial, 397 home-dwelling patients with hip fractures were randomised to comprehensive geriatric care (CGC) in a geriatric ward or traditional orthopaedic care (OC). Patients in the CGC group had significantly better mobility and function 4 months after discharge. This study explores group differences in drug prescribing and possible associations with the outcomes in the main study. METHODS: Drugs prescribed at admission and discharge were registered from hospital records...
May 26, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28544188/novel-tool-for-deprescribing-in-chronic-patients-with-multimorbidity-list-of-evidence-based-deprescribing-for-chronic-patients-criteria
#2
Aitana Rodríguez-Pérez, Eva Rocío Alfaro-Lara, Sandra Albiñana-Perez, María Dolores Nieto-Martín, Jesús Díez-Manglano, Concepción Pérez-Guerrero, Bernardo Santos-Ramos
AIM: To create a tool to identify drugs and clinical situations that offers an opportunity of deprescribing in patients with multimorbidity. METHODS: A literature review completed with electronic brainstorming, and subsequently, a panel of experts using the Delphi methodology were applied. The experts assessed the criteria identified in the literature and brainstorming as possible situations for deprescribing. They were also asked to assess the influence of life prognosis in each criterion...
May 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28526147/pharmacologic-considerations-of-anesthetic-agents-in-geriatric-patients
#3
REVIEW
Maunak V Rana, Lara K Bonasera, Gregory J Bordelon
Aging is a natural process of declining organ function and reserve. Census data show that the geriatric population is expected to grow to nearly 30%. More than half of geriatric patients have 1 or more surgical procedures in their lifetimes. Moreover, this is the population at greatest risk of morbidity and mortality with any given complication. There is remarkable variability in health across the age spectrum, from fit to frail and compromised. This variability requires a unique approach to anesthetic delivery and drug dosing on an individual basis to avoid complications such as postoperative cognitive dysfunction and delirium...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28509429/chronic-kidney-disease-a-likely-underestimated-component-of-multimorbidity-in-older-patients-with-chronic-obstructive-pulmonary-disease
#4
REVIEW
Andrea Corsonello, Filippo Aucella, Claudio Pedone, Raffaele Antonelli-Incalzi
The coexistence of chronic kidney disease and chronic obstructive pulmonary disease, two age-related conditions, has important clinical and prognostic implications. Respiratory failure is associated with important changes in glomerular and tubulointerstitial function. In contrast, renal failure can affect lung function, mainly by adding a restrictive component or causing complications, such as uremic pulmonary edema and pleural effusion. The effect of age on renal and pulmonary function adds to the complexity of the interplay between the kidney and the lung in these patients...
May 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28497256/-pharmacotherapy-of-parkinson-s-disease-aspects-of-drug-safety
#5
REVIEW
S Müller-Rebstein, C Trenkwalder, W H Oertel, C Culmsee, G Eckermann, G U Höglinger
BACKGROUND: This overview focuses on the aspects of the pharmacotherapy of Parkinson's disease, which is one of the most common disorders of the nervous system. This article presents the complexity of the pharmacotherapy of geriatric patients with neurological diseases. OBJECTIVES: Information about the potential risk factors and aspects of drug safety in the pharmacotherapy of Parkinson's disease. MATERIALS AND METHODS: Selective literature search using PubMed and the scientific-clinical experience of the authors...
May 11, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28493216/appropriateness-of-oral-anticoagulants-for-the-long-term-treatment-of-atrial-fibrillation-in-older-people-results-of-an-evidence-based-review-and-international-consensus-validation-process-oac-forta-2016
#6
REVIEW
Martin Wehling, Ronan Collins, Victor M Gil, Olivier Hanon, Roland Hardt, Martin Hoffmeister, Pedro Monteiro, Terence J Quinn, Dieter Ropers, Giuseppe Sergi, Freek W A Verheugt
BACKGROUND: Age appropriateness of anticoagulants for stroke prevention in atrial fibrillation is uncertain. OBJECTIVE: To review oral anticoagulants for the treatment of atrial fibrillation in older (age >65 years) people and to classify appropriate and inappropriate drugs based on efficacy, safety and tolerability using the Fit-fOR-The-Aged (FORTA) classification. METHODS: We performed a structured comprehensive review of controlled clinical trials and summaries of individual product characteristics to assess study and total patient numbers, quality of major outcome data and data of geriatric relevance...
May 10, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28490560/nursing-home-team-care-deprescribing-study-a-stepped-wedge-randomised-controlled-trial-protocol
#7
Chong-Han Kua, Cindy Ying Ying Yeo, Cheryl Wai Teng Char, Cheryl Wei Yan Tan, Poh Ching Tan, Vivienne Sl Mak, Shaun Wen Huey Lee, Ian Yi-Onn Leong
INTRODUCTION: An ageing population has become an urgent concern for Asia in recent times. In nursing homes, polypharmacy has also become a compounding issue. Deprescribing practice is an evidence-based strategy to provide a better outcome in this group of patients; however, its implementation in nursing homes is often challenging, and prospective outcome data on deprescribing practice in the elderly is lacking. Our study assesses the implementation of team-care deprescribing to understand the benefits of this practice in geriatric setting and to explore the factors affecting deprescribing practice...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28488143/methodology-of-phase-ii-clinical-trials-in-metastatic-elderly-breast-cancer-a-literature-review
#8
REVIEW
B Cabarrou, L Mourey, F Dalenc, L Balardy, D Kanoun, H Roché, J M Boher, M E Rougé-Bugat, Thomas Filleron
PURPOSE: As the incidence of invasive breast cancer will increase with age, the number of elderly patients with a diagnosis metastatic breast cancer will also rise. But the use of cytotoxic drugs in elderly metastatic breast cancer patients is not systematic and is dreaded by medical oncologists. The need for prospective oncologic data from this population seems increasingly obvious. The main objective of this review is to investigate design and characteristics of phase II trials that assess activity and feasibility of chemotherapies in elderly advanced/metastatic breast cancer patients...
May 9, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28467020/the-association-of-medications-with-sedative-properties-with-oral-health-behaviour-in-community-dwelling-older-people
#9
A Tiisanoja, A-M Syrjälä, K Komulainen, S Hartikainen, H Taipale, M Knuuttila, P Ylöstalo
OBJECTIVES: The objective of this study was to determine whether drugs with sedative properties are related to oral health behaviour-such as frequency of toothbrushing, using toothpaste and dental visits-and oral hygiene, measured by the number of teeth with dental plaque, among community-dwelling older people. METHODS: The study population consisted of 159 community-dwelling, dentate, non-smoking, older people from the Oral Health GeMS study (Geriatric Multidisciplinary Strategy for the Good Care of Older People study)...
May 3, 2017: International Journal of Dental Hygiene
https://www.readbyqxmd.com/read/28465867/differences-in-antipsychotic-related-adverse-events-in-adult-pediatric-and-geriatric-populations
#10
Hersh Sagreiya, Yi-Ren Chen, Narmadan A Kumarasamy, Karthik Ponnusamy, Doris Chen, Amar K Das
In recent years, antipsychotic medications have increasingly been used in pediatric and geriatric populations, despite the fact that many of these drugs were approved based on clinical trials in adult patients only. Preliminary studies have shown that the "off-label" use of these drugs in pediatric and geriatric populations may result in adverse events not found in adults. In this study, we utilized the large-scale U.S. Food and Drug Administration (FDA) Adverse Events Reporting System (AERS) database to look at differences in adverse events from antipsychotics among adult, pediatric, and geriatric populations...
February 26, 2017: Curēus
https://www.readbyqxmd.com/read/28458417/evaluation-of-polypharmacy-and-appropriateness-of-prescription-in-geriatric-patients-a-cross-sectional-study-at-a-tertiary-care-hospital
#11
K B Rakesh, Mukta N Chowta, Ashok K Shenoy, Rajeshwari Shastry, Sunil B Pai
OBJECTIVES: To assess the polypharmacy and appropriateness of prescriptions in geriatric patients in a tertiary care hospital. METHODS: An observational study was done in geriatric patients (>60 years) of either gender. The data collected from patients included: Socio-demographic data such as age, gender, marital status, educational status, socioeconomic status, occupation, nutritional status, history of alcohol/smoking, exercise history, details of comorbid diseases, medication history, findings of clinical examination etc...
January 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28436193/association-between-using-medications-with-anticholinergic-properties-and-short-term-cognitive-decline-among-older-men-a-retrospective-cohort-study-in-taiwan
#12
Yi-Hui Wu, Chih-Jen Wang, Cheng-Hao Hung, Liang-Yu Chen, Ming-Hsien Lin, Pei-Ning Wang, Liang-Kung Chen
AIM: The use of anticholinergic drugs had been strongly linked to adverse health outcomes among older adults, especially in cognitive impairment or dementia. The present study aimed to evaluate the cognitive decline related to the use of anticholinergic drugs among older men living in the veterans' homes in Taiwan. METHODS: This retrospective cohort study was a substudy of The Longitudinal Older Veterans study. A total of 274 residents living in four Taiwan veterans' homes and receiving two consecutive Mini-Mental State Examinations within the interval of 6 months from January 2012 to December 2014 were enrolled in the present study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28436187/slow-gait-speed-as-a-predictor-of-1-year-cognitive-decline-in-a-veterans-retirement-community-in-southern-taiwan
#13
Chiao-Lin Hsu, Chih-Kuang Liang, Mei-Chen Liao, Ming-Yueh Chou, Yu-Te Lin
AIM: Slow gait speed has been associated with mortality, poor physical function and disability in older people. Our aim was to evaluate the association between slow gait speed and rapid cognitive decline among oldest-old men in Taiwan. METHODS: We carried out a longitudinal cohort study in a veterans' retirement community, and enrolled 249 male residents aged 80 years and older. Slow gait speed was defined as <1 m/s, and rapid cognitive decline was defined as a Mini-Mental State Examination (MMSE) decline of ≥3 points over 1 year...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28432019/feasibility-of-mini-tablets-as-a-flexible-drug-delivery-tool
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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