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Polypharmacy

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https://www.readbyqxmd.com/read/28918484/drug-herb-interactions-in-the-elderly-patient-with-ibd-a-growing-concern
#1
REVIEW
Haider Rahman, Marina Kim, Galen Leung, Jesse A Green, Seymour Katz
Inflammatory bowel disease (IBD), which includes conditions such as Crohn's disease and ulcerative colitis, is becoming more prevalent with the elderly being the fastest growing group. Parallel to this, there is an increasing interest in the use of complementary and alternative medicine (CAM). Nearly half of patients with IBD have used CAM at one time. The elderly patients, however, are burdened by comorbid conditions, polypharmacy, and altered functional status. With increasing use of complementary and alternative medicine in our elderly patients with IBD, it is vital for the provider to provide counsel on drug-herb potential interactions...
September 16, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28918428/modification-of-cardiovascular-pharmacotherapy-in-palliative-care-patients-with-cancer-narrative-review
#2
Tomasz Pasierski
Palliative care cancer patients are treated with many drugs especially at the end of life. Limiting of polypharmacy a decreases the risk of associated adverse effects, medical errors and harmful drug interactions The time lag to benefit of many medications used for cardiovascular diseases or risk factors like hypertension, hypercholesterolemia is frequently longer than palliative care cancer patient's life expectancy. It is ethically appropriate to modify, even to discontinue cardiovascular pharmacotherapy when there is no prospect of benefit...
September 13, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28917331/-polypharmacy-and-geriatric-psychiatry
#3
Abdelkrim Hamzaoui, André Joulié, Yahya El Dachri
The ageing of the population is synonymous with multiple pathologies and polypharmacy, which increases risk factors. François-Tosquelles general hospital carried out a study into the administering of medicines within the ageing population in psychiatry and drew up an assessment of professional practices with regard to polypharmacy in geriatric psychiatry.
September 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28917330/-oral-administration-of-medicines-in-elderly-patients-and-adaptation-of-galenic-forms
#4
Éric Pautas, Lasamy Bui, Alexandra Monti, Sébastien Krypciak, Anastasia Obraztsova, Eléna Paillaud
Physiological ageing and pathologies can have an influence on the pharmacology of numerous medicines, leading to serious iatrogenic accidents, polypharmacy and incorrect use of a medicine in elderly people. An observational study carried out in a short-stay geriatric unit focused on the issues surrounding the difficulties the elderly may encounter when taking medicines and the prevalence of the manipulation of galenic forms.
September 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28917110/prevalence-and-predictors-of-potentially-inappropriate-prescribing-of-central-nervous-system-and-psychotropic-drugs-among-elderly-patients-a-national-population-study-in-korea
#5
Hyeonseok Cho, Junjeong Choi, Young-Sang Kim, Sang Joon Son, Kang Soo Lee, Hee-Jin Hwang, Hye-Young Kang
OBJECTIVES: To investigate the prevalence of potentially inappropriate prescribing (PIP) of central nervous system and psychotropic (CNS-PS) drugs to the Korean elderly population, and to identify PIP-associated factors. METHODS: Ambulatory care visits were identified from the 2013 National Aged Patient Sample (HIRA-APS-2013) data, composed of 20% random samples of all enrollees in the universal health security program aged ≥65 years. The CNS-PS section of Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria version 2 was used to identify PIP at these visits...
September 6, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28914100/acute-myeloid-leukemia-and-the-infectious-diseases-consultant
#6
Victor Mulanovich, Dimitrios P Kontoyiannis
Infectious complications following treatment of acute myeloid leukemia (AML) are important causes of morbidity and mortality. The spectrum and complexity of these infections is reflected by the severe net state of immunosuppression of AML patients, that is dynamic and continuously changing, the polypharmacy, including the widespread use of anti-infectives and the complex epidemiology of severe and frequently resistant pathogens afflicting these patients. Infectious diseases (ID) consultants having a critical mass of expertise and intimate knowledge of the intricacies of leukemia care, add considerable value in improving outcomes of patients with AML who develop infections...
September 15, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28905359/guideline-recommended-medications-and-physical-function-in-older-adults-with-multiple-chronic-conditions
#7
Gail McAvay, Heather G Allore, Andrew B Cohen, Danijela Gnjidic, Terrence E Murphy, Mary E Tinetti
BACKGROUND/OBJECTIVES: The benefit or harm of a single medication recommended for one specific condition can be difficult to determine in individuals with multiple chronic conditions and polypharmacy. There is limited information on the associations between guideline-recommended medications and physical function in older adults with multiple chronic conditions. The objective of this study was to estimate the beneficial or harmful associations between guideline-recommended medications and decline in physical function in older adults with multiple chronic conditions...
September 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28904969/sociodemographic-and-clinical-characteristics-of-centenarians-in-mexico-city
#8
Valdés-Corchado Pedro, Ruiz-Hernández Arturo, Pérez-Moreno Alejandro, Rosas-Carrasco Oscar
BACKGROUND: There is little evidence about the demography and health status of adults aged 100 years and over in Latin America and there are no studies in Mexico. OBJECTIVES: To describe the demographic characteristics and health status of centenarians residing in Mexico City. METHODS: This is a cross-sectional study using a population base of 393 community-dwelling centenarians in Mexico City. A comprehensive geriatric assessment was performed, including demographic information and health status...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28899661/frailty-polypharmacy-and-health-outcomes-in-older-adults-the%C3%A2-frailty-and-dependence-in-albacete-study
#9
Bonaga Beatriz, Pedro M Sánchez-Jurado, Marta Martínez-Reig, Gabriel Ariza, Leocadio Rodríguez-Mañas, Danijela Gnjidic, Tránsito Salvador, Pedro Abizanda
BACKGROUND/OBJECTIVES: To investigate if polypharmacy modifies the association between frailty and health outcomes in older adults. DESIGN: Ongoing cohort study. SETTING: Albacete City, Spain. PARTICIPANTS: A total for 773 participants, 457 women (59.1%), over age 70 years from the FRADEA Study. MEASUREMENTS: Frailty phenotype, polypharmacy considered as the chronic use of 5 or more drugs, and comorbidity were collected at the baseline visit...
September 9, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28894183/gut-microbiota-composition-is-associated-with-polypharmacy-in-elderly-hospitalized-patients
#10
Andrea Ticinesi, Christian Milani, Fulvio Lauretani, Antonio Nouvenne, Leonardo Mancabelli, Gabriele Andrea Lugli, Francesca Turroni, Sabrina Duranti, Marta Mangifesta, Alice Viappiani, Chiara Ferrario, Marcello Maggio, Marco Ventura, Tiziana Meschi
Reduced biodiversity and increased representation of opportunistic pathogens are typical features of gut microbiota composition in aging. Few studies have investigated their correlation with polypharmacy, multimorbidity and frailty. To assess it, we analyzed the fecal microbiota from 76 inpatients, aged 83 ± 8. Microbiome biodiversity (Chao1 index) and relative abundance of individual bacterial taxa were determined by next-generation 16S rRNA microbial profiling. Their correlation with number of drugs, and indexes of multimorbidity and frailty were verified using multivariate linear regression models...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28893219/a-case-of-a-four-year-old-child-adopted-at-eight-months-with-unusual-mood-patterns-and-significant-polypharmacy
#11
Magdalena Romanowicz, Alastair J McKean, Jennifer Vande Voort
BACKGROUND: Long-term effects of neglect in early life are still widely unknown. Diversity of outcomes can be explained by differences in genetic risk, epigenetics, prenatal factors, exposure to stress and/or substances, and parent-child interactions. Very common sub-threshold presentations of children with history of early trauma are challenging not only to diagnose but also in treatment. CASE PRESENTATION: A Caucasian 4-year-old, adopted at 8 months, male patient with early history of neglect presented to pediatrician with symptoms of behavioral dyscontrol, emotional dysregulation, anxiety, hyperactivity and inattention, obsessions with food, and attachment issues...
September 11, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28892805/an-evaluation-of-the-central-nervous-system-medication-use-and-frailty-among-residents-of-aged-care-homes-in-malaysia
#12
Syed Shahzad Hasan, Chia Siang Kow, Kaeshaelya Thiruchelvam, David Weng Kwai Chong, Syed Imran Ahmed
BACKGROUND/AIMS: Old age and institutionalization in care homes are associated with increased use of risk medications affecting the central nervous system (CNS). This study evaluated medication utilization and appropriateness; and assessed frailty among residents of Malaysian aged care homes. METHODS: The subjects of this study included 202 elderly (≥65 years) residents of 17 aged care homes in suburban peninsular Malaysia. Frailty was measured using the Groningen Frailty Indicator (GFI) score and independence in daily living was measured as KATZ activity of daily living score...
September 12, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28892271/potential-drug-drug-interactions-and-polypharmacy-in-institutionalized-elderly-patients-in-a-public-hospital-in-brazil
#13
Ellen Carolina Dias Castilho, Adriano Max Moreira Reis, Tatiana Longo Borges, Lilian Dias Castilho Siqueira, Adriana Inocenti Miasso
INTRODUCTION: Despite the impact on patient safety and the fact that prevalence is higher in older patients, previous research did not analyse drug-drug interactions (DDIs) in view of nursing care of elderly psychiatric patients. AIM: To identify potential drug-drug interactions and polypharmacy in prescriptions of aged inpatients with psychiatric disorders and analyse associated factors. METHODS: In this retrospective cross-sectional study, we analysed the medical records of institutionalized patients diagnosed with psychiatric disorders (n = 94), aged >60 years, and prescribed multiple medications...
September 11, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/28889761/safety-issues-associated-with-using-medication-to-treat-overactive-bladder
#14
George Araklitis, Linda Cardozo
The mainstay of overactive bladder treatment is the use of anticholinergic medication with its common side effects well known. This review focused on three less well-known safety issues when treating OAB. Areas covered: Patients with increased anticholinergic load are at risk of cognitive decline, dementia or even death. The elderly are particularly at risk due to polypharmacy. Botulinum toxin carries the risk of high urinary residuals, urinary tract infection and need to self catheterise. The use of vaginal oestrogens may improve OAB symptoms, but there is concern in those with a history of breast cancer...
September 10, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28885219/recognition-of-possible-risk-factors-for-clinically-significant-drug-drug-interactions-among-indian-people-living-with-hiv-receiving-highly-active-antiretroviral-therapy-and-concomitant-medications
#15
Poka Siva Sai Lakshmi Priyanka, Danturulu Muralidhar Varma, Kavyasri Immadisetti, Radhakrishnan Rajesh, Sudha Vidyasagar, Vasudeva Guddattu
BACKGROUND: Greatest challenges for clinician is to recognize risk factors for clinically significant drug interactions (CSDIs). There is a lack of awareness about CSDIs among healthcare professionals in India. OBJECTIVE: To recognize all possible risk factors for drug-drug interactions (DDIs) and to identify clinically significant drug interactions (CSDIs), the prevalence, pattern of occurrence of DDIs in People Living with HIV (PLW-HIV) receiving highly active antiretroviral therapy (HAART) and concomitant medications...
2017: International Journal of Risk & Safety in Medicine
https://www.readbyqxmd.com/read/28880484/health-checkup-behavior-and-individual-health-beliefs-in-older-adults
#16
Mika Okura, Mihoko Ogita, Miki Yamamoto, Toshimi Nakai, Tomoko Numata, Hidenori Arai
AIM: Despite Japan being a developed nation, half of its older population does not attend regular health checkups. The aim of the present study was to examine the individual health beliefs and personal recommendations that strongly influence health checkup attendance among community-dwelling older adults. METHODS: In 2013, questionnaires were sent to 5401 community-dwelling older adults who were not receiving long-term institutionalized care. The response rate was 94...
September 7, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28880144/-periodical-medication-review-bigger-and-better
#17
R J van Marum
The Netherlands' practice guideline 'Polypharmacy in older people' (2012) proposed selecting patients who would benefit from a periodical medication review. The guideline committee made it clear that firm evidence supporting selection was lacking, and recent studies evaluating the effects of medication review on relevant patient-related outcomes have failed to show a positive effect on almost any of these outcomes. Regulatory authorities have advised expanding the target population for medication review. We have to conclude, however, that rather than implementing medication reviews across a broad population of older people, many with a low risk of adverse events, it may be more cost-effective to limit this potentially useful but time-consuming intervention to a more select population who would benefit the most from it...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28877256/medication-and-supplement-use-in-older-people-with-and-without-intellectual-disability-an-observational-cross-sectional-study
#18
Jure Peklar, Mitja Kos, Máire O'Dwyer, Mary McCarron, Philip McCallion, Rose Anne Kenny, Martin C Henman
INTRODUCTION: Understanding the medication and supplement use of aging people is critical to ensuring that health service providers in primary care can optimise use of these agents. An increasing number of people with different levels of intellectual disability (ID) are living in the community and becoming for the first time substantial users of primary health care services. This, however, brings new challenges that need to be addressed at the primary health care level. We quantified the use of medicines and food supplements and described the associated patterns of morbidity in the two comparable cohorts of aging population with and without intellectual disability...
2017: PloS One
https://www.readbyqxmd.com/read/28876959/chirality-and-neuropsychiatric-drugs-an-update-on-stereoselective-disposition-and-clinical-pharmacokinetics-of-bupropion
#19
Ranjeet Prasad Dash, Rana Rais, Nuggehally R Srinivas
Bupropion, an antidepressant drug has been approved as a racemate containing equal amounts of R- and S- enantiomers. Recently, the chirality of bupropion has received significant attention in the delineation of stereoselective pharmacokinetic and disposition data. Although the non-stereoselective metabolism of bupropion was well established, the emerging data suggests that bupropion exhibits complex stereoselective metabolism, leading to the formation of various stereoisomeric metabolites. Along with the chiral pharmacokinetics of bupropion, hydroxybupropion, threohydrobupropion and erythrohydrobupropion, the metabolism data also provided insights into the roles of both CYP2B6 and CYP2C19 enzymes in the stereoselective disposition...
September 6, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/28873291/increase-in-psychoactive-drug-prescriptions-in-the-years-following-autism-spectrum-diagnosis-a-population-based-cohort-study
#20
Caroline Croteau, Laurent Mottron, Nancy Presse, Jean-Eric Tarride, Marc Dorais, Sylvie Perreault
BACKGROUND: Psychoactive medications are commonly prescribed to autistic individuals, but little is known about how their use changes after diagnosis. OBJECTIVES: This study describes the use of psychoactive drugs in children and young adults newly diagnosed with autism spectrum, between the year before and up to 5 years after diagnosis. METHODS: Multivariable logistic regression was used to examine the relationship between the use psychoactive drugs before the first diagnosis of autism spectrum condition (from 1998 to 2010), and the clinical and demographic characteristics, identified from public health care databases in Quebec...
August 18, 2017: Journal of Population Therapeutics and Clinical Pharmacology
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