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Drug use in the elderly

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https://www.readbyqxmd.com/read/29331969/temporal-trends-in-antithrombotic-treatment-of-real-world-uk-patients-with-newly-diagnosed-atrial-fibrillation-findings-from-the-garfield-af-registry
#1
Patricia N Apenteng, Haiyan Gao, Fd Richard Hobbs, David A Fitzmaurice
OBJECTIVE: To investigate evolving patterns in antithrombotic treatment in UK patients with newly diagnosed non-valvular atrial fibrillation (AF). DESIGN: Prospective, multicentre, international registry. SETTING: 186 primary care practices in the UK. PARTICIPANTS: 3482 participants prospectively enrolled in four sequential cohorts (cohort 2 (C2) n=830, diagnosed September 2011 to April 2013; cohort 3 (C3) n=902, diagnosed April 2013 to June 2014; cohort 4 (C4) n=850, diagnosed July 2014 to June 2015; cohort 5 (C5) n=900, diagnosed June 2015 to July 2016)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331774/the-synergy-of-vitamin-c-with-decitabine-activates-tet2-in-leukemic-cells-and-significantly-improves-overall-survival-in-elderly-patients-with-acute-myeloid-leukemia
#2
Huihui Zhao, Huayuan Zhu, Jiayu Huang, Yu Zhu, Ming Hong, Han Zhu, Jingjing Zhang, Shan Li, Lijia Yang, Yun Lian, Shuai Wang, Jianping Mao, Yaoyu Chen, Jianyong Li, Sixuan Qian
BACKGROUND: Decitabine is widely used in the treatment of acute myeloid leukemia (AML) in elderly patients. Low-dose Vitamin C has also been indicated to induce DNA demethylation at the cellular level. However, little is known whether low-dose Vitamin C has a synergistic effect with decitabine in clinic. METHODS: The effect of combined low-dose Vitamin C and decitabine on cell proliferation, the cell cycle, apoptosis and the expression level and activity of TET2 was investigated in HL60 and NB4 human leukemic cells...
January 2, 2018: Leukemia Research
https://www.readbyqxmd.com/read/29330781/a-review-of-the-methods-and-associated-mathematical-models-used-in-the-measurement-of-fat-free-mass
#3
REVIEW
Jaydeep Sinha, Stephen B Duffull, Hesham S Al-Sallami
Fat-free mass (FFM) represents the lean component of the body devoid of fat. It has been shown to be a useful predictor of drug dose requirements, particularly in obesity where the excess fat mass does not contribute to drug clearance. However, measuring FFM involves complex and/or expensive experimental methodologies that preclude their use in routine clinical practice. Thus, models to predict FFM from readily measurable variables, such as body weight and height, have been developed and are used in both population pharmacokinetic modelling and clinical practice...
January 12, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29325730/use-of-cardiovascular-polypills-for-the-secondary-prevention-of-cerebrovascular-disease
#4
J Masjuan, J Gállego, J M Aguilera, J F Arenillas, M Castellanos, F Díaz, J C Portilla, F Purroy
INTRODUCTION: There is little control of cardiovascular (CV) risk factors in secondary prevention after an ischaemic stroke, in part due to a lack of adherence to treatment. The CV polypill may contribute to proper treatment adherence, which is necessary for CV disease prevention. This study aimed to establish how and in what cases the CV polypill should be administered. METHODS: A group of 8 neurologists drafted consensus recommendations using structured brainstorming and based on their experience and a literature review...
January 8, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29325370/-association-between-carotid-artery-plaques-and-all-cause-mortality-and-cardiovascular-events
#5
W Li, F Ma, Y M Jiang, J J Li, L Song, S H Chen, X M Liu, X Q Li, S L Wu
Objective: To observe the association of carotid artery plaque with all-cause mortality and cardiovascular events. Methods: A total of 7 017 participants who completed the carotid sonography examination between 2010 and 2011 were selected from the stroke and the elderly prospective cohort Kailuan study. The participants of stroke cohort received health examination between 2006 and 2007, and participants of elderly cohort received health examination between 2010 and 2011. All participants were divided into plaque group (3 285 cases) and without plaque group (3 732 cases) according to with or without carotid artery plaque...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29319495/investigation-of-the-age-dependency-of-vancomycin-clearance-by-population-pharmacokinetic-modeling
#6
Muhammad Usman, Manfred Fobker, Georg Hempel
PURPOSE: The aim of this study was to evaluate the influence of age and other possible covariates on vancomycin clearance in order to define a possible cut off value of age for dose optimization in elderly patients from data obtained during therapeutic drug monitoring. MATERIALS AND METHODS: Population pharmacokinetic analysis of 256 samples obtained from 144 patients was performed by using NONMEM®. A one-compartment model was applied as the base model with first-order conditional estimation method with interaction (FOCE-I)...
January 10, 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29318007/severe-haematuria-of-lower-urinary-tract-origin-with-low-dose-dabigatran-use-in-three-indian-elderly-patients-unresolved-issues-in-the-safety-of-novel-oral-anticoagulants
#7
Upinder Kaur, Sankha Shubhra Chakrabarti, Sukdev Manna, Indrajeet Singh Gambhir
Dabigatran is a newer oral direct thrombin inhibitor approved by the United States Food and Drug Administration and the European Medicines Agency (EMA). The proper dosage of the drug, the potential for adverse drug reactions and the nature of bleeds with use of this drug as with other novel oral anticoagulants (NOACs), in the elderly population are still areas of uncertainty. Despite the existence of a specific antibody, idarucizumab which is an antidote to dabigatran toxicity, management of dabigatran-induced bleeds is an undefined area especially in resource constrained settings...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29316948/traditional-uses-of-medicinal-plants-practiced-by-the-indigenous-communities-at-mohmand-agency-fata-pakistan
#8
Muhammad Abdul Aziz, Muhammad Adnan, Amir Hasan Khan, Abdelaaty Abdelaziz Shahat, Mansour S Al-Said, Riaz Ullah
BACKGROUND: Plant-derived products have an imperative biological role against certain pathogenic organisms and were considered to be a major source of modern drugs. Rural people residing in developing countries are relying on traditional herbal medical system due to their strong believe and minimum access to allopathic medicines. Hence, ethnomedicinal knowledge is useful for the maintenance of community's based approaches under this medical system. Present study was carried out in an unexplored remote tribal area of Pakistan to investigate and document the existing ethnomedicinal knowledge on local flora...
January 9, 2018: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/29315727/considerations-for-optimal-blood-pressure-goals-in-the-elderly-population-a-review-of-emergent-evidence
#9
Diana X Cao, Rebecca J C Tran
Recent hypertension clinical trials and national guideline updates have created a debate on the most appropriate treatment goals in elderly patients with hypertension. In 2014, recommendations by the Eighth Joint National Committee (JNC 8) allowed a more lenient goal for patients 60 years and older compared with previous guidelines. Since then, several large clinical trials and meta-analyses have added more information regarding strict versus lenient treatment goals. Most recently, the American College of Cardiology and American Heart Association Task Force published their highly-anticipated hypertension guideline developed in conjunction with nine additional interdisciplinary organizations...
January 8, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29310996/appropriateness-of-statin-prescription-in-the-elderly
#10
M Ruscica, C Macchi, C Pavanello, A Corsini, A Sahebkar, C R Sirtori
Statins, the most widely used drugs in the Western world, have become a pivotal component in the primary and secondary prevention of vascular diseases. Although benefits have been well documented in younger-than-75-year-old individuals, the value of statins in people aged >75years and over is controversial. The CTT meta-analysis calculated an absolute risk reduction of 0.6%/year per 38.7mg/dl reduction in LDL-C levels in patients aged >75years, that would translate into a number needed to treat of 167...
January 5, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29310076/epilepsy-in-an-elderly-population-classification-etiology-and-drug-resistance
#11
Lizbeth Hernández-Ronquillo, Scott Adams, Stephanie Ballendine, Jose F Téllez-Zenteno
PURPOSE: To characterize epilepsy in an elderly population and describe the prevalence of drug resistant epilepsy (DRE) using recently validated International League Against Epilepsy (ILAE) criteria. METHODS: Using a case-control design, 72 patients aged 60 years and older (cases) and 223 patients under age 60 (controls) were identified from the Saskatchewan Epilepsy Program database. Patients' charts were retrospectively reviewed. Bivariate and multiple logistic regression analyses were performed to identify variables that were associated with epilepsy in elderly patients...
January 3, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29309391/alzheimer-disease-and-related-disorders-and-out-of-pocket-health-care-spending-and-burden-among-elderly-medicare-beneficiaries
#12
Nilanjana Dwibedi, Patricia A Findley, Constance Wiener R, Chan Shen, Usha Sambamoorthi
OBJECTIVE: To estimate the excess burden of out-of-pocket health care spending associated with Alzheimer disease and related disorders (ADRD) among older individuals (age 65 y and older). METHODS: We adopted a retrospective, cross-sectional study design with data from 2012 Medicare Current Beneficiary Survey. The study sample comprised of elderly community-dwelling individuals who had positive total health care expenditures, and enrolled in Medicare throughout the calendar year (462 with ADRD, and 7160 without ADRD)...
January 5, 2018: Medical Care
https://www.readbyqxmd.com/read/29307505/practical-considerations-in-medical-cannabis-administration-and-dosing
#13
REVIEW
Caroline A MacCallum, Ethan B Russo
Cannabis has been employed medicinally throughout history, but its recent legal prohibition, biochemical complexity and variability, quality control issues, previous dearth of appropriately powered randomised controlled trials, and lack of pertinent education have conspired to leave clinicians in the dark as to how to advise patients pursuing such treatment. With the advent of pharmaceutical cannabis-based medicines (Sativex/nabiximols and Epidiolex), and liberalisation of access in certain nations, this ignorance of cannabis pharmacology and therapeutics has become untenable...
January 4, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29307053/antipsychotics-use-2006-2013-trends-in-prevalence-and-incidence-and-characterization-of-users
#14
François Montastruc, Anne Bénard-Laribière, Pernelle Noize, Elodie Pambrun, Fabienne Diaz-Bazin, Marie Tournier, Bernard Bégaud, Antoine Pariente
PURPOSE: The present study was conducted to describe antipsychotic (AP) prevalent and incident use, characteristics of AP users, and their trends in the French population. METHODS: A cross-sectional study was repeated yearly from January 1, 2007 to December 31, 2013 (for prevalence analysis) or to December 31, 2012 (for incidence analysis) using the French Health Insurance reimbursement database (Echantillon Généraliste de Bénéficiaires, EGB). For each year studied, prevalent and incident AP users were described in terms of age and gender overall, and according to the type of AP (FGAPs or SGAPs) used at index date...
January 6, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29306884/retrospective-cohort-study-on-risk-of-hearing-loss-in-patients-with-rheumatoid-arthritis-using-claims-data
#15
Chung-Ming Huang, Hsuan-Ju Chen, Po-Hao Huang, Gregory J Tsay, Joung-Liang Lan, Fung-Chang Sung
OBJECTIVES: Population studies on hearing loss (HL) associated with rheumatoid arthritis (RA) are lacking. This study investigated the risk of developing HL in patients with RA using a nationwide population cohort. SETTING: The population-based insurance claims data in the Taiwan National Health Insurance Research Database. DESIGN: Retrospective cohort study followed up RA cohort and control cohort without RA frequency matched by sex, age and diagnosis year...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29306006/evaluation-of-truncated-g-protein-delivered-by-live-attenuated-salmonella-as-a-vaccine-against-respiratory-syncytial-virus
#16
Puyuan Tian, Di Xu, Zhixiang Huang, Fanjing Meng, Jinheng Fu, Hua Wei, Tingtao Chen
Human respiratory syncytial virus (RSV) can cause severe acute lower respiratory tract disease leading to numerous hospitalizations and deaths in the infant and elderly populations worldwide, while no vaccine or effective drug is available for RSV infections. In the present study, truncated G protein was successfully expressed both in prokaryotic and eukaryotic system, and high levels of serum IgG in response to truncated G protein were observed both in GD-protein group (intramuscularly with purified GD protein) and GD-VNP20009 group (challenged via the oral route with 1 × 109 CFU of pLIVE-RSV-GD-VNP20009 strains) since 21th day, and GD-VNP20009 significantly reduced the productions of IL-1β, IL-6, and TNF-α, histamine and pathological features caused by the RSV Long strain (P < ...
January 3, 2018: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29304725/patient-perceived-barriers-and-facilitators-to-the-implementation-of-a-medication-review-in-primary-care-a-qualitative-thematic-analysis
#17
Mirella Carolin Uhl, Christiane Muth, Ferdinand Michael Gerlach, Goentje-Gesine Schoch, Beate Sigrid Müller
BACKGROUND: Although polypharmacy can cause adverse health outcomes, patients often know little about their medication. A regularly conducted medication review (MR) can help provide an overview of a patient's medication, and benefit patients by enhancing their knowledge of their drugs. As little is known about patient attitudes towards MRs in primary care, the objective of this study was to gain insight into patient-perceived barriers and facilitators to the implementation of an MR. METHODS: We conducted a qualitative study with a convenience sample of 31 patients (age ≥ 60 years, ≥3 chronic diseases, taking ≥5 drugs/d); in Hesse, Germany, in February 2016...
January 5, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29304513/nonvitamin-k-antagonist-oral-anticoagulants-use-in-patients-with-atrial-fibrillation-and-bioprosthetic-heart-valves-prior-surgical-valve-repair-a-multicenter-clinical-practice-experience
#18
Vincenzo Russo, Emilio Attena, Carmine Mazzone, Francesca Esposito, Valentina Parisi, Ciro Bancone, Anna Rago, Gerardo Nigro, Raffaele Sangiuolo, Antonio D' Onofrio
This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR [international normalized ratio], Elderly, Drugs or alcohol) score values were 3...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29303707/the-influence-of-disease-modifying-anti-rheumatic-drugs-and-corticosteroids-on-the-association-between-rheumatoid-arthritis-and-skin-cancer-a-nationwide-retrospective-case-control-study-in-taiwan
#19
Hui-Wen Tseng, Ling-Ying Lu, Hing-Chung Lam, Kuo-Wang Tsai, Wei-Chun Huang, Yow-Ling Shiue
OBJECTIVES: To investigate the influence of corticosteroids and disease-modifying anti-rheumatic drugs (DMARDs, including conventional synthetic and biologic DMARDs) treatment on the association between rheumatoid arthritis (RA) and non-melanoma skin cancer (NMSC). METHODS: This nationwide retrospective case-control study retrieved data from Taiwan National Health Insurance Research Database during 1995-2013. Cases with newly-diagnosed NMSC (n=19,603) were matched with control without NMSC in a 1:1 ratio according to age, sex, and reference date...
December 15, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29302568/severe-hyponatremia-associated-with-escitalopram
#20
Gautam Rawal, Raj Kumar, Sankalp Yadav
Hyponatremia is a rare but potentially fatal complication of selective serotonin reuptake inhibitor (SSRI) therapy with only limited cases of escitalopram as the causative drug. We report the case of a 54-year-old hypertensive female who was admitted to the hospital with seizure episode and subsequently diagnosed to have severe hyponatremia due to SSRI-induced syndrome of inappropriate antidiuretic hormone (SIADH) with the cause attributed to the short history of intake of escitalopram for depression. All SSRIs, including escitalopram, can cause SIADH and should be used with caution in the depressive patients with regular monitoring of electrolytes, especially in the elderly...
April 2017: Journal of Family Medicine and Primary Care
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