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Drug use in the elderly

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https://www.readbyqxmd.com/read/28336159/the-anticholinergic-impregnation-scale-towards-the-elaboration-of-a-scale-adapted-to-prescriptions-in-french-psychiatric-settings
#1
Jeanne Briet, Hervé Javelot, Edwige Heitzmann, Luisa Weiner, Catherine Lameira, Philippe D'Athis, Marie Corneloup, Jean-Louis Vailleau
PURPOSE: Some drugs have anticholinergic activity and can cause peripheral or central side effects. Several scales exist to evaluate the potential anticholinergic effect of prescribed drugs but: (i) they are validated in the elderly and mainly assess the cognitive side effect of treatments; (ii) they do not concern some of the drugs frequently used in clinical psychiatry in France. The aim of our study is to develop a new scale, the anticholinergic impregnation scale (AIS), with drugs used in France and based on an assessment of the drugs used against peripheral anticholinergic adverse effects...
February 17, 2017: Thérapie
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/28334908/adherence-and-persistence-of-patients-using-oral-bone-sparing-drugs-in-primary-care
#3
Babette C van der Zwaard, Wesley van Hout, Jacqueline G Hugtenburg, Henriëtte E van der Horst, Petra J M Elders
Aim.: Studies based on pharmacy medication records have shown suboptimal adherence and persistence of osteoporosis treatment with oral bone sparing drugs (OBSD). Little is known about adherence and persistence of OBSD treatment in primary care. We assessed adherence and persistence of OBSD use of patients in general practices and identified associated factors. Methods.: Using electronic medical records, adherence and persistence of newly prescribed treatment with OBSD in patients from 16 general practices was retrospectively assessed...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28331326/lithium-in-late-life-mania-a-systematic-review
#4
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/28331324/update-on-the-treatment-of-parkinson-s-disease-psychosis-role-of-pimavanserin
#5
REVIEW
Brianna L Combs, Arthur G Cox
Parkinson's disease (PD) has a prevalence of nearly 1 million people in the USA, with increasing incidence in the elderly population. Generally, the age of presentation is between 55 and 65 years, with the likelihood of diagnosis increasing as patients reach the age of 80 years or above. Some of the common treatments for PD increase dopamine levels in the brain. Dopaminergic therapy helps to improve motor and non-motor symptoms, but it is not without risks. Dopaminergic therapy can cause confusion, delirium, and psychotic-like behavior...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28330645/design-of-fixed-dose-combination-and-physicochemical-characterization-of-enteric-coated-bilayer-tablet-with-circadian-rhythmic-variations-containing-telmisartan-and-pravastatin-sodium
#6
Daoqi Luo, Joo Hee Kim, Chulhun Park, Euichaul Oh, Jun Bum Park, Jing-Hao Cui, Qing-Ri Cao, Beom-Jin Lee
The aim of this study was to investigate a fixed dose combination (FDC) of telmisartan (TEL) and pravastatin sodium (PRA) in enteric-coated bilayer tablets, which was designed for once-daily bedtime dose in order to match circadian rhythmic variations of hypertension and cholesterol synthesis and optimize the patient friendly dosing treatment. Due to the poor aqueous solubility of TEL, a ternary solid dispersions (SD) consisting of TEL, polyethylene glycol 6000 (PEG 6000) and magnesium oxide (MgO) were designed to enhance its dissolution rate in intestinal fluid...
March 18, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28330633/association-between-psychotropic-and-cardiovascular-iatrogenic-alerts-and-risk-of-hospitalizations-in-elderly-people-treated-for-dementia-a-self-controlled-case-series-study-based-on-the-matching-of-2-french-health-insurance-databases
#7
Lorene Zerah, Jacques Boddaert, Armelle Leperre-Desplanques, Dominique Bonnet-Zamponi, Marc Verny, Jean Deligne, Pierre-Yves Boelle
BACKGROUND: Elderly people are at risk of repeated hospitalizations, some of which may be drug related and preventable. In 2011, a group of French healthcare experts selected 5 iatrogenic alerts (IAs), based on criteria identified in a literature search and from their professional experience, to assess the appropriateness of medication in elderly patients. OBJECTIVES: Our objective was to examine the association between hospitalizations and IAs in elderly patients treated for Alzheimer disease who are particularly sensitive to adverse drug events...
March 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28327188/allopurinol-and-the-risk-of-ventricular-arrhythmias-in-the-elderly-a-study-using-us-medicare-data
#8
Jasvinder A Singh, John Cleveland
BACKGROUND: There are no published human studies investigating whether the use of allopurinol, the most commonly used medication for the treatment of hyperuricemia in gout, the most common type of inflammatory arthritis in adults, has any beneficial effects on ventricular electrophysiology. The objective of our study was to assess whether allopurinol use is associated with a reduction in the risk of ventricular arrhythmias (VA). METHODS: We used the 5% random sample of Medicare beneficiaries from 2006-2012 to examine new allopurinol use and the risk of incident VA...
March 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28326804/a-novel-approach-in-the-management-of-right-sided-endocarditis-percutaneous-vegectomy-using-the-angiovac-cannula
#9
Ashwin K Thiagaraj, Meenal Malviya, Wah W Htun, Tesfaye Telila, Stephen A Lerner, Mahir D Elder, Theodore L Schreiber
The AngioVac is a vacuum-based device introduced in 2012 to percutaneously remove undesirable material from the intravascular system. In scattered reports, the AngioVac has been used for removal of device lead vegetations and right-sided thrombi. In this article, we describe three cases of right-sided endocarditis treated with AngioVac: a mobile mass extending from the vena cava into the right atrium, large native tricuspid vegetations, and bioprosthetic tricuspid vegetations. This device shows benefit in reducing vegetation load, decreasing septic lung embolization, and reducing reinfection in active intravenous drug users...
March 22, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28324595/recent-advances-in-developing-antiviral-therapies-for-respiratory-syncytial-virus
#10
REVIEW
Brian C Shook, Kai Lin
Respiratory syncytial virus (RSV) infection presents a significant health challenge in small children, the elderly and immunocompromised patients. There is still a high unmet medical need among patients with RSV infection, and no specific antiviral therapy is available. The only approved agents are palivizumab, which has to be given prophylactically, mainly in high-risk infants, and ribavirin, which is rarely used due to toxicity concerns and questionable benefits. Efforts to develop new antiviral agents have been hampered by the perceived need for high safety hurdles in pediatric patient populations use and the lack of well-characterized druggable targets...
April 2017: Topics in Current Chemistry (Journal)
https://www.readbyqxmd.com/read/28324215/surgical-treatment-of-osteoporotic-thoraco-lumbar-compressive-fractures-the-use-of-pedicle-screw-with-augmentation-pmma
#11
Massimo Girardo, P Cinnella, G Gargiulo, P Viglierchio, A Rava, S Aleotti
INTRODUCTION: The osteoporosis prevalence in population is age related. The aim of this single-center observational study was evaluate the middle- to long-term performance of cement (PMMA) augmented fenestrated pedicle screws in elderly patients with thoraco-lumbar compressive fractures by osteoporosis. MATERIALS AND METHODS: From 2011 to 2015 we treated 52 patients (20 males and 32 females) suffering from somatic osteoporotic fractures (T10-L2). The average age was 73...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28321243/cardiac-drug-therapy-considerations-in-the-elderly
#12
REVIEW
Mohamed Ayan, Naga Venkata Pothineni, Aisha Siraj, Jawahar L Mehta
Elderly individuals constitute a majority of patients encountered in current cardiovascular clinical practice. Management of these patients is a clinical challenge owing to a multitude of factors. Although medications such as statins have been shown to reduce cardiovascular mortality in the general population, evidence supporting the use of these drugs in patients greater than 75 years of age is sparse. Furthermore, aging associated changes in organ function and associated comorbidities influence the pharmacokinetics of multiple medications and can potentiate drug toxicity...
December 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28320328/expenditures-of-medicine-use-in-hypertensive-diabetic-elderly-and-physical-activity-and-engagement-in-walking-cross-secctional-analysis-of-sabe-survey
#13
Denise Rodrigues Bueno, Maria de Fátima Nunes Marucci, Luis Alberto Gobbo, Manuela de Almeida-Roediger, Yeda Aparecida de Oliveira Duarte, Maria Lucia Lebrão
BACKGROUND: The literature shows the inverse association between physical activity level (PAL) and chronic diseases that have a significant burden over health care costs. However, in upper-middle income countries and in elderly population this information are scarce. OBJECTIVE: To describe the annual drug expenditures for the hypertensive and diabetic elderly population in Brazil and to analyze the association with PAL and engagement in walking. METHODS: This cross sectional study is part of SABE Survey and comprised 806 hypertensive and/or diabetic elderly (≥60 years old)...
March 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28316784/characteristics-of-an-optimized-patient-information-material-for-elderly-patients-with-obstructive-pulmonary-diseases-based-on-patients-and-experts-assessment
#14
Gábor Tomisa, Alpár Horváth, Brigitta Dombai, Lilla Tamási
BACKGROUND: Life-long regular use of drugs is necessary in chronic diseases like asthma and COPD. There are several methods to improve adherence including patient information and education; however, their effectiveness on the basis of practical experience is often lower than originally planned and expected. Our objective is to develop a patient information material based on the recommendations of patients and their treating healthcare professionals to fulfill their needs. METHODS: A survey was conducted among pulmonologists (N = 262), asthma nurses (N = 102), general practitioners (N = 321) and patients with obstructive pulmonary disease (N = 978) using on line questionnaires...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28299963/cost-effectiveness-analysis-on-the-use-of-fidaxomicin-and-vancomycin-to-treat-clostridium-difficile-infection-in-france
#15
Maureen Watt, Aurélien Dinh, Alban Le Monnier, Patrick Tilleul
BACKGROUND: Fidaxomicin is a macrocyclic antibiotic with proven efficacy against Clostridium difficile infection (CDI) in adults. It was licensed in France in 2012, but, due to higher acquisition costs compared with existing treatments, healthcare providers require information on its cost/benefit profile. OBJECTIVE: To compare healthcare costs and health outcomes of fidaxomicin and vancomycin, as reference treatment for CDI. METHODS: A Markov model was used to simulate the treatment pathway, over 1 year, of adult patients with CDI receiving fidaxomicin or vancomycin...
March 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28298798/regional-anesthesia-in-patients-of-aged-99-years-in-clopidogrel-use
#16
Bruno Brasileiro, Luiz Eduardo Imbelloni
The risk of neuraxial block in patients treated with antiplatelet drugs are uncertain. Elderly patients often have low physiological reserve, delaying surgery can lead to a high rate of morbidity and mortality. The aim of this paper is to present a case of a patient with 99 years using clopidogrel undergoing regional anesthesia for surgical treatment of hip fracture without complications.
January 2017: Anesthesia, Essays and Researches
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
#17
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/28292271/two-elderly-patients-with-normal-creatinine-and-elevated-cystatin-c-a-case-report
#18
Amina Loesment-Wendelmuth, Elke Schaeffner, Natalie Ebert
BACKGROUND: Serum creatinine concentration (Scr) and creatinine based GFR estimating equations (eGFRcr) are commonly used as an estimate of GFR. However, serum creatinine concentration is also influenced by non-GFR determinants. This case report presents two elderly patients with normal Scr but elevated serum cystatin C concentration (Scys) where the exclusive assessment of Scr would have lead to an overestimation of GFR and would have misclassified the patients as having a normal kidney function...
March 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28290728/diffuse-large-b-cell-lymphoma-in-the-elderly-standard-treatment-and-new-perspectives
#19
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/28290080/a-retrospective-cohort-study-of-acute-kidney-injury-risk-associated-with-antipsychotics
#20
Yawen Jiang, Jeffrey S McCombs, Susie H Park
BACKGROUND: A recent large database analysis raised concerns of potential acute kidney injury (AKI) risk associated with antipsychotics. However, whether individual atypical and typical antipsychotics are associated with differential AKI risks has not been investigated. OBJECTIVE: The current study compared the risks of AKI and known causes of AKI associated with a broad range of atypical and typical antipsychotics. METHOD: This retrospective cohort analysis used January 2007-June 2013 US nationwide Humana claims data to define episodes of antipsychotic drug therapy for patients with schizophrenia and bipolar disorder...
March 13, 2017: CNS Drugs
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