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Drug use in the elderly

Juliano de Souza Caliari, Lilian Andreia Fleck Reinato, Daiana Patrícia Marchetti Pio, Letícia Pimenta Lopes, Renata Karina Reis, Elucir Gir
OBJECTIVE: To analyze factors related to the quality of life of elderly people living with HIV/AIDS. METHOD: A cross-sectional study was carried out with people aged 50 years or more in a specialized outpatient clinic. The data collection was by means of an interview. For the analysis of data and characterization of the sample, descriptive statistics and comparison tests were used. The project met the ethical requirements. RESULTS: Participants were 81 users aged 50 to 75 years, mean age was 57...
2018: Revista Brasileira de Enfermagem
Joshua W Elder, Garrett DePalma, Jesse M Pines
The opioid epidemic is the most significant modern-day, public health crisis. Physicians and lawmakers have developed methods and practices to curb opioid use. This article describes one method, prescription drug monitoring programs (PDMP), through the lens of how to optimize use for emergency departments (ED). EDs have rapidly become a central location to combat opioid abuse and drug diversion. PDMPs can provide emergency physicians with comprehensive prescribing information to improve clinical decisions around opioids...
March 2018: Western Journal of Emergency Medicine
Yohei Kubota, Toh Yoon Ezekiel Wong
When elderly patients are prescribed many different medications, the risk for developing serious adverse events should be kept in mind. One of these adverse events is agranulocytosis, which, although rare, can be life-threatening if left untreated. The majority of agranulocytosis cases are caused by drugs, including antibiotics. Here, we report a case of severe agranulocytosis in a 96-year-old woman following antibiotic therapy which was successfully managed using recombinant human granulocyte colony-stimulating factor (rhG-CSF) and the appropriate choice of antibiotics to treat her concomitant infection...
2018: Case Reports in Medicine
Phillip J Tully, Ruth Peters, Karine Pérès, Kaarin J Anstey, Christophe Tzourio
BACKGROUND: Emerging genetic, ex-vivo, and clinical trial evidence indicates that calcium channel blockers (CCB) can improve mood and cognitive function. The objective of this study was to examine the effect of selective serotonin reuptake inhibitor (SSRI) therapy augmented with CCB on depression and cognitive decline in an elderly population with hypertension. METHODS: Prospective study of 296 persons treated with SSRI and antihypertensive drugs. Baseline and two year clinic assessments were used to categorize participants as users of SSRI + CCB (n = 53) or users of SSRI + other antihypertensives (n = 243)...
March 21, 2018: International Psychogeriatrics
Han-Yun Tseng, Shu-Han Yu, Chun-Yi Lee, Wen-Hao Huang, Seng-Loong Huang, Chi-Shin Wu, Yen-Feng Chiu, Chao A Hsiung
BACKGROUND: Sedative-hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan. METHODS: A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders...
March 21, 2018: International Psychogeriatrics
Mohammad Heidari, Mansureh Ghodusi Borujeni, Mansour Ghafourifard, Rahim Ali Sheikhi
INTRODUCTION: The prevalence of various diseases in the elderly has increased the use of drugs, which is coupled with age-related physiological changes and places the elderly at risk for multiple side effects. The present study aimed to determine awareness, attitudes and practices of elderly towards self-medication. MATERIALS AND METHODS: The sample included 300 participants over 60 years under any of the health centers in urban and rural areas of Abadeh city, who were selected based on stratified random sampling method...
March 20, 2018: Drug Research
Tony K L Kiang
Elbasvir and grazoprevir, in a fixed-dose combination of 50 and 100 mg, respectively, have received approval to be administered orally once daily, with or without ribavirin, for the treatment of chronic hepatitis C virus (HCV) infections. The absorption characteristics of elbasvir and grazoprevir have been adequately summarized, although differences were observed for grazoprevir (e.g., increased exposure at steady state in patients), but not elbasvir, between healthy and HCV-infected subjects. Inconsistencies with respect to absorption were also reported on the effects of food or acid reducers (famotidine or pantoprazole) in the literature...
March 20, 2018: European Journal of Drug Metabolism and Pharmacokinetics
F Willeboordse, F G Schellevis, M C Meulendijk, J G Hugtenburg, P J M Elders
Background Implementation of clinical medication reviews in daily practice is scarcely evaluated. The Opti-Med intervention applied a structured approach with external expert teams (pharmacist and physician) to conduct medication reviews. The intervention was effective with respect to resolving drug related problems, but did not improve quality of life. Objective The objective of this process evaluation was to gain more insight into the implementation fidelity of the intervention. Setting Process evaluation alongside a cluster randomized trial in 22 general practices and 518 patients of 65 years and over...
March 20, 2018: International Journal of Clinical Pharmacy
Tejas K Patel, Parvati B Patel
PURPOSE: The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal ADRAd ), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal ADRAd . METHODS: We identified prospective ADRAd -related studies via screening of the PubMed and Google Scholar databases with appropriate key terms...
March 19, 2018: European Journal of Clinical Pharmacology
Xiao-Meng Zhang, Fan Li, Bing Zhang, Xiao-Fen Chen, Jing-Zhu Piao
The common Aconitum herbs in clinical application mainly include Aconiti Radix(Chuanwu), Aconiti Kusnezoffii Radix(Caowu) and Aconiti Lateralis Radix Praeparaia(Fuzi), all of which have toxicity. Therefore, the safety of using Chinese patent drugs including Aconitum herbs has become an hot topic in clinical controversy. Based on the data-mining methods, this study explored the characteristics and causes of adverse drug reactions/events (ADR/ADE) of the Chinese patent drugs including Aconitum, in order to provide pharmacovigilance and rational drug use suggestions for clinical application...
January 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Mitsuhiro Akiyama, Tsutomu Takeuchi
IgG4-related disease is a heterogeneous immune-mediated fibroinflammatory condition that can affect every single organ. This disease is more prevalent in the elderly (the mean age of patients is above 60 years) and the prevalence rate is estimated to be over 4.6 per 100,000 population. Before making a diagnosis, the exclusion of malignancies, lymphoma, anti-neutrophil cytoplasmic antibody-associated vasculitis, multicentric Castleman disease, and other mimickers is crucial for appropriate treatment. Broad management guidelines have been published emphasizing the need for prompt treatment and the use of glucocorticoids as first-line drug therapy for induction of remission...
March 15, 2018: Drugs & Aging
Sébastien Chanoine, Margaux Sanchez, Isabelle Pin, Sofia Temam, Nicole Le Moual, Agnès Fournier, Christophe Pison, Jean Bousquet, Pierrick Bedouch, Marie-Christine Boutron-Ruault, Raphaëlle Varraso, Valérie Siroux
Multi-medication related to multimorbidity is common in the elderly with asthma. We aimed at comprehensively characterizing medications used by elderly women, and assessing how multi-medication impacts on asthma prognosis.We performed network-based analyses on drug administrative databases to visualize the prevalence of drug classes and their interconnections among 17,458 elderly women from the Asthma-E3N study, including 4,328 women with asthma. Asthma groups sharing similar medication profiles were identified by clustering method relying on all medications and were studied in association with adverse asthma events (uncontrolled asthma, attacks/exacerbations, and poor asthma-related quality of life)...
March 15, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
L Lafarge, L Bourguignon, N Bernard, T Vial, M-J Dehan-Moya, B De La Gastine, S Goutelle
Beta-blockers are widely prescribed in elderly patients and may induce severe adverse drug reactions. We report a case of bisoprolol-induced bradycardia in an elderly patient with impaired renal function and use of cytochrome P450 inhibitors. A literature review has been performed in order to analyze pharmacokinetic risk factors of beta-blockers overdosing in geriatrics. Various mechanisms can result in decreased elimination of beta-blockers. These mechanisms vary according to the beta-blocker agent and may be combined in some individuals, especially elderly patients...
March 12, 2018: Annales de Cardiologie et D'angéiologie
Philippe Desmarais, Catherine Miville, Ángela Milán-Tomás, Quoc Dinh Nguyen, Carmen Ojeda-López, Mario Masellis, Sandra E Black, Danielle Molinari Andrade, Nathan Herrmann
OBJECTIVES: To analyze age representation trends over time in antiepileptic drug (AED) trials and to assess trial design elements as possible barriers to enrollment of elderly patients. MATERIALS AND METHODS: We searched MEDLINE, EMBASE, and PsycINFO, and meta-analyzed demographic data of cohorts enrolled in randomized controlled trials (RCTs) of AEDs published since 1991. Data analysis included trends of age representation over time and trial design elements associated with average age of enrolled cohorts...
March 6, 2018: Epilepsy Research
Lone Baandrup, Bjørn H Ebdrup, Jesper Ø Rasmussen, Jane Lindschou, Christian Gluud, Birte Y Glenthøj
BACKGROUND: Prolonged treatment with benzodiazepines is common practice despite clinical recommendations of short-term use. Benzodiazepines are used by approximately 4% of the general population, with increased prevalence in psychiatric populations and the elderly. After long-term use it is often difficult to discontinue benzodiazepines due to psychological and physiological dependence. This review investigated if pharmacological interventions can facilitate benzodiazepine tapering. OBJECTIVES: To assess the benefits and harms of pharmacological interventions to facilitate discontinuation of chronic benzodiazepine use...
March 15, 2018: Cochrane Database of Systematic Reviews
Stephan R Bohl, Lars Bullinger, Frank G Rücker
The majority of patients with acute myeloid leukemia (AML) are older and exhibit a poor prognosis even after intensive therapy. Inducing differentiation and apoptosis of leukemic blasts by DNA-hypomethylating agents, like e.g. azacytidine (AZA) and decitabine (DAC), represent well-tolerated alternative treatment approaches. Both agents show convincing response as single agents in AML. However, there is a lack of knowledge regarding molecular mechanisms and predictive biomarkers for these agents. Areas covered: This review will (i) provide an overview of the current knowledge of molecular mechanisms underlying the action of these drugs, (ii) report promising predictive biomarkers, (iii) elude on new combined treatment options, and (iv) discuss novel approaches to improve outcomes...
March 15, 2018: Expert Review of Hematology
Sheikh Arslan Sehgal, Mirza A Hammad, Rana Adnan Tahir, Hafiza Nisha Akram, Faheem Ahmad
BACKGROUND: As the number of elderly persons increases, neurodegenerative diseases are becoming ubiquitous. There is currently a great need for knowledge concerning management of old-age neurodegenerative diseases; the most important of which are: Alzheimer's disease, Parkinson's disease, Amyotrophic Lateral Sclerosis, and Huntington's disease. OBJECTIVE: To summarize the potential of computationally predicted molecules and targets against neurodegenerative diseases...
March 15, 2018: Current Neuropharmacology
Gian Marco Rosa, Danilo Baccino, Alberto Valbusa, Carolina Scala, Fabio Barra, Claudio Brunelli, Simone Ferrero
Overactive bladder (OAB) syndrome is common in the general population, particularly in elderly patients. Antimuscarinic drugs (AMs) are considered the mainstay pharmaceutical treatment of OAB whereas β3-adrenoceptor agonists, such as mirabegron, represent a good alternative. Owing to the important role of muscarinic and β3 receptors in cardiovascular (CV) tissue and to the fact that OAB patients often have CV comorbidities, the safety-profile of these drugs constitute an important challenge. Area covered: The aim of this review is to evaluate the CV effects of AMs and mirabegron in OAB...
March 15, 2018: Expert Opinion on Drug Safety
L Li, Q Mo, T Mo, Y Liu, J L Tian, Z Wan
Objective: To investigate the clinical characteristics and pharmaceutical therapy of elderly patients with chronic heart failure (CHF). Methods: Using the multi-center retrospective cross-sectional survey, we analyzed 1 799 hospitalized patients with CHF as the main cause and NYHA heart function classification Ⅱ-Ⅳ from nine tertiary hospitals of Tianjin during March 2014 to February 2016. According to age, we divided them into non- elderly group(age<65 years), normal elderly group (age ≥65-79 years), and the old elderly group(age≥80 years)...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Richard Njouom, Isabelle Siffert, Gaëtan Texier, Guillaume Lachenal, Mathurin Cyrille Tejiokem, Jacques Pépin, Arnaud Fontanet
Cameroon is thought to have one of the highest prevalences of Hepatitis C virus (HCV) infection in the world (4·9% among adults). A marked cohort effect exists in several communities where ≈50% of the elderly are infected. Better assessment of HCV distribution is needed for planning treatment programs. We tested for HCV antibodies 14150 capillary blood samples collected during the 2011 Demographic and Health Survey, whose participants were representative of the Cameroonian population aged 15-49 (both genders) and 50-59 years (men only)...
March 13, 2018: Journal of Viral Hepatitis
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