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Drug use in the elderly

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https://www.readbyqxmd.com/read/28226014/-pharmacotherapeutic-profile-and-factors-associated-with-polypharmacy-among-the-elderly-in-aiquara-bahia-brazil-2014
#1
Alessandra Santos Sales, Marta Gabriele Santos Sales, Cezar Augusto Casotti
Objective: to describe the drugs used and analyze the factors associated with polypharmacy in the elderly, in Aiquara, Bahia, Brazil. Methods: this is a census cross-sectional study, conducted in February 2014, through an interview using standardized form. Results: among the 272 elderly respondents, 53.3% used only prescribed medication and 31.6% used at least one medication not prescribed; the prevalence of polypharmacy was 29.0%; cardiovascular drugs were the most used in polypharmacy (n=390; 37...
January 2017: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
https://www.readbyqxmd.com/read/28224957/-medicines-and-elderly-patients-abuse-dependency-or-attraction
#2
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/28224284/complementary-and-alternative-medicine-use-in-rheumatoid-arthritis-considerations-for-the-pharmacological-management-of-elderly-patients
#3
REVIEW
Sizheng Zhao, Fred Otieno, Asan Akpan, Robert J Moots
Complementary and alternative medicines (CAMs) are widely used by patients with rheumatoid arthritis (RA); however, a significant proportion of these patients do not inform their physicians. This has many potential implications in a group of predominantly elderly patients with altered pharmacokinetics, comorbidities and polypharmacy of potentially toxic drugs. CAM usage may affect compliance and pharmacokinetics of conventional therapy for RA and comorbidities; therefore, physicians should engage patients in dialogues regarding CAM usage...
February 21, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28223671/-analysis-of-nedaplatin-dose-in-patients-with-impaired-renal-function
#4
Risa Araki, Hidetaka Iwamizu, Tomomi Kataoka, Yasuo Kumakura, Masayuki Miyazaki, Taku Nagai, Yuichi Ando, Kiyofumi Yamada
Nedaplatin(NDP)is a platinum derivative anticancer drug.An NDP dose of 100mg/m2 every 4 weeks is recommended in non-elderly Japanese patient because a higher dose may lead to myelosuppression, such as thrombocytopenia.In a pharmacokinetic analysis, thrombocytopenia was significantly correlated with renal function.However, the correct dose in patients with impaired renal function remains unclear.To evaluate the usefulness of dose reduction in patients with renal dysfunction, we conducted a retrospective study...
February 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28218801/do-cancer-survivors-change-their-prescription-drug-use-for-financial-reasons-findings-from-a-nationally-representative-sample-in-the-united-states
#5
Zhiyuan Zheng, Xuesong Han, Gery P Guy, Amy J Davidoff, Chunyu Li, Matthew P Banegas, Donatus U Ekwueme, K Robin Yabroff, Ahmedin Jemal
BACKGROUND: There is limited evidence from nationally representative samples about changes in prescription drug use for financial reasons among cancer survivors in the United States. METHODS: The 2011 to 2014 National Health Interview Survey was used to identify adults who reported ever having been told they had cancer (cancer survivors; n = 8931) and individuals without a cancer history (n = 126,287). Measures of changes in prescription drug use for financial reasons included: 1) skipping medication doses, 2) taking less medicine, 3) delaying filling a prescription, 4) asking a doctor for lower cost medication, 5) buying prescription drugs from another country, and 6) using alternative therapies...
February 20, 2017: Cancer
https://www.readbyqxmd.com/read/28217306/sexual-function-of-patients-with-heart-failure-facts-and-numbers
#6
EDITORIAL
Tiny Jaarsma
Approximately 60% to 87% of patients with heart failure (HF) report sexual problems, and numbers as low as 31% of HF patients younger than 70 have normal sexual function. When compared with healthy elders, the amount of perceived sexual dysfunction might be similar (around 56%), but patients with HF are reporting more erectile dysfunction (ED) and also perceive that their HF symptoms (20%) or HF medication (10%) is the cause for their problems. The prevalence of ED is highly prevalent in men with cardiac disease and reported in up to 81% of cardiac patients, compared with 50% in the general older population...
February 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28215914/fecal-carriage-of-mdros-in-a-population-of-lebanese-elderly-dynamics-and-impact-on-bacterial-fitness
#7
Caren Challita, Elias Dahdouh, Michel Attieh, Iman Dandachi, Elio Ragheb, Roy Taoutel, Carl Tanba, Ziad Daoud
Muti-Drug Resistant Organisms (MDROs) are problematic all over the world, especially in Lebanon. High fecal carriage rates of MDR Enterobacteriaceae were reported from Lebanese nursing homes. Some studies show that MDROs have a fitness cost as compared to sensitive isolates. In this study, the competitive growth of MDR Escherichia coli obtained from fecal samples from elderly is assessed. Fecal swabs from ten elderly patients from a Lebanese nursing home were obtained between June and December, 2015. Isolates were identified by API 20E and antimicrobial susceptibilities were determined...
February 16, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28215652/polypathology-polypharmacy-medication-regimen-complexity-and-drug-therapy-appropriateness
#8
N Gómez Aguirre, A Caudevilla Martínez, L Bellostas Muñoz, M Crespo Avellana, J Velilla Marco, J Díez-Manglano
Polypathological patients are usually elderly and take numerous drugs. Polypharmacy affects 85% of these individuals and is not associated with greater survival. On the contrary, polypharmacy exposes these individuals to more adverse effects, such as weight loss, falls, functional and cognitive impairment and hospitalisations. The complexity of a drug regimen covers more aspects than the simple number of drugs consumed. The galenic form, the dosage and the method for preparing the drug can impede the understanding of and compliance with prescriptions...
February 16, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28212616/general-practitioners-views-on-long-term-prescription-and-use-of-problematic-and-potentially-inappropriate-medication-for-oldest-old-patients-a-qualitative-interview-study-with-gps-cim-triad-study
#9
Nadine Janis Pohontsch, Kathrin Heser, Antje Löffler, Britta Haenisch, Debora Parker, Tobias Luck, Steffi G Riedel-Heller, Wolfgang Maier, Frank Jessen, Martin Scherer
BACKGROUND: Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM. METHODS: As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list)...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28211810/therapeutics-of-neurotransmitters-in-alzheimer-s-disease
#10
Ramesh Kandimalla, P Hemachandra Reddy
Alzheimer's disease (AD) is a progressive neurodegenerative disease, characterized by the loss of memory, multiple cognitive impairments and changes in the personality and behavior. Several decades of intense research have revealed that multiple cellular changes are involved in disease process, including synaptic damage, mitochondrial abnormalities and inflammatory responses, in addition to formation and accumulation of amyloid-β (Aβ) and phosphorylated tau. Although tremendous progress has been made in understanding the impact of neurotransmitters in the progression and pathogenesis of AD, we still do not have a drug molecule associated with neurotransmitter(s) that can delay disease process in elderly individuals and/or restore cognitive functions in AD patients...
February 15, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28211099/sedation-with-orally-administered-midazolam-in-elderly-dental-patients-with-major-neurocognitive-disorder
#11
Lena Rignell, Mona Mikati, Madeleine Wertsén, Catharina Hägglin
OBJECTIVE: The aim of this study was to evaluate acceptance of treatment after oral sedation with midazolam in dental patients with major neurocognitive disorder. BACKGROUND: Midazolam is commonly used as premedication in paediatric dentistry, oral surgery and people suffering from dental fear. Little is known about its use in other patient groups. METHODS: Dental and sedation records of 61 patients (64% women) sedated with midazolam were examined retrospectively...
February 17, 2017: Gerodontology
https://www.readbyqxmd.com/read/28208878/a-study-of-medication-compliance-in-geriatric-patients-with-chronic-illnesses-at-a-tertiary-care-hospital
#12
R Shruthi, R Jyothi, H P Pundarikaksha, G N Nagesh, T J Tushar
INTRODUCTION: Geriatric population is more prone for various chronic and recurrent illnesses like diabetes mellitus, hypertension, IHD, arthritic, neurodegenerative, gastrointestinal, ocular, genitourinary, respiratory disorders etc., which may require chronic medication with multiple drugs. Poor compliance in this age group accounts for medication wastage with increased cost of healthcare and substantial worsening of the disease with disability or death. Most of the human and economic costs associated with non adherence can be avoided by improving medication adherence...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203065/oral-drug-therapy-in-elderly-with-dysphagia-between-a-rock-and-a-hard-place
#13
REVIEW
Serena Logrippo, Giovanna Ricci, Matteo Sestili, Marco Cespi, Letizia Ferrara, Giovanni F Palmieri, Roberta Ganzetti, Giulia Bonacucina, Paolo Blasi
Demographic indicators forecast that by 2050, the elderly will account for about one-third of the global population. Geriatric patients require a large number of medicines, and in most cases, these products are administered as solid oral solid dosage forms, as they are by far the most common formulations on the market. However, this population tends to suffer difficulties with swallowing. Caregivers in hospital geriatric units routinely compound in solid oral dosage forms for dysphagic patients by crushing the tablets or opening the capsules to facilitate administration...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28202082/bone-morphogenetic-proteins-and-myostatin-pathways-key-mediator-of-human-sarcopenia
#14
Manuel Scimeca, Eleonora Piccirilli, Francesca Mastrangeli, Cecilia Rao, Maurizio Feola, Augusto Orlandi, Elena Gasbarra, Elena Bonanno, Umberto Tarantino
BACKGROUND: Sarcopenia, osteoporosis and osteoarthritis are the most frequent musculoskeletal disorders affecting older people. The main aim of this study was to test the hypothesis that the balance between BMPs and myostatin pathways regulates the age-related muscle degeneration in OP and OA patients. To this end, we investigated the relationship among the expression of BMP-2/4-7, myostatin and phosphorylated Smads1-5-8 and the muscle quality, evaluated in term of fibers atrophy and satellite cells activity...
February 15, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28198990/corticosteroids-and-hip-fracture-risk-in-elderly-respiratory-patients-epic-greece-cohort
#15
Anna Karakatsani, Michail Katsoulis, Eleni Klinaki, Antonia Trichopoulou
INTRODUCTION: In an ageing population the prevalence of osteoporosis and chronic respiratory diseases is expected to increase in the near future. Interestingly, several forms of corticosteroids, drugs implicated in osteoporosis pathogenesis, are prescribed to respiratory patients without taking into consideration their age and risk for osteoporotic fractures. The aim of this study was to investigate the risk for hip fracture of the elder individuals who are taking corticosteroids for respiratory disease, including inhalers...
2017: Adv Respir Med
https://www.readbyqxmd.com/read/28198563/frequency-and-predictors-of-analgesic-prescribing-in-u-s-nursing-home-residents-with-persistent-pain
#16
Kevin M Fain, G Caleb Alexander, David D Dore, Jodi B Segal, Andrew R Zullo, Carlos Castillo-Salgado
OBJECTIVES: To quantify prescription analgesic use of elderly nursing home (NH) residents with persistent noncancer pain and to identify individual and facility traits associated with no treatment. DESIGN: Cross-sectional study. SETTING: Linked Minimum Data Set (MDS) assessments; Online Survey, Certification and Reporting (OSCAR) records; and Medicare Part D claims. PARTICIPANTS: Individuals aged 65 and older with persistent noncancer pain were identified from a cross-section of all long-stay U...
February 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28198157/a-review-of-the-antiviral-properties-of-black-elder-sambucus-nigra-l-products
#17
REVIEW
Randall S Porter, Robert F Bode
Black elder (Sambucus nigra L.) has a long ethnobotanical history across many disparate cultures as a treatment for viral infection and is currently one of the most-used medicinal plants worldwide. Until recently, however, substantial scientific research concerning its antiviral properties has been lacking. Here, we evaluate the state of current scientific research concerning the use of elderberry extract and related products as antivirals, particularly in the treatment of influenza, as well as their safety and health impacts as dietary supplements...
February 15, 2017: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/28194534/the-impact-of-physician-level-drug-budgets-on-prescribing-behavior
#18
Katharina Elisabeth Fischer, Taika Koch, Karel Kostev, Tom Stargardt
To contain pharmaceutical spending, drug budgets have been introduced across health systems. Apart from analyzing whether drug budgets fulfill their overall goal of reducing spending, changes in the cost and quality of prescribing and the enforcement mechanisms put in place need evaluation to assess the effectiveness of drug budgets at the physician level. In this study, we aim to analyze the cost and quality of prescribing conditional on the level of utilization of the drug budget and in view of varying levels of enforcement in cases of overspending...
February 13, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28192477/impact-of-early-in-hospital-medication-review-by-clinical-pharmacists-on-health-services-utilization
#19
Corinne M Hohl, Nilu Partovi, Isabella Ghement, Maeve E Wickham, Kimberlyn McGrail, Lisa N Reddekopp, Boris Sobolev
BACKGROUND: Adverse drug events are a leading cause of emergency department visits and unplanned admissions, and prolong hospital stays. Medication review interventions aim to identify adverse drug events and optimize medication use. Previous evaluations of in-hospital medication reviews have focused on interventions at discharge, with an unclear effect on health outcomes. We assessed the effect of early in-hospital pharmacist-led medication review on the health outcomes of high-risk patients...
2017: PloS One
https://www.readbyqxmd.com/read/28191906/intracardiac-echocardiography-for-verification-for-left-atrial-appendage-thrombus-presence-detected-by-transesophageal-echocardiography-the-actionice-ii-study
#20
Jakub Baran, Beata Zaborska, Roman Piotrowski, Malgorzata Sikora-Frąc, Ewa Pilichowska-Paszkiet, Piotr Kułakowski
BACKGROUND: Transesophageal echocardiography (TEE) remains the gold standard for exclusion of left atrial appendage (LAA) thrombus in patients scheduled for direct electrical cardioversion (DEC) or atrial fibrillation (AF) ablation. Recently, intracardiac echocardiography (ICE) of the pulmonary artery (PA) has been shown to provide excellent LAA images and to be useful in verification of equivocal TEE findings. HYPOTHESIS: ICE of the PA may have a role in detecting false-positive TEE results...
February 13, 2017: Clinical Cardiology
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