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Drug use in the elderly

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https://www.readbyqxmd.com/read/28936626/the-impact-of-frailty-on-icu-and-30-day-mortality-and-the-level-of-care-in-very-elderly-patients-%C3%A2-%C3%A2-80%C3%A2-years
#1
Hans Flaatten, Dylan W De Lange, Alessandro Morandi, Finn H Andersen, Antonio Artigas, Guido Bertolini, Ariane Boumendil, Maurizio Cecconi, Steffen Christensen, Loredana Faraldi, Jesper Fjølner, Christian Jung, Brian Marsh, Rui Moreno, Sandra Oeyen, Christina Agwald Öhman, Bernardo Bollen Pinto, Ivo W Soliman, Wojciech Szczeklik, Andreas Valentin, Ximena Watson, Tilemachos Zaferidis, Bertrand Guidet
PURPOSE: Very old critical ill patients are a rapid expanding group in the ICU. Indications for admission, triage criteria and level of care are frequently discussed for such patients. However, most relevant outcome studies in this group frequently find an increased mortality and a reduced quality of life in survivors. The main objective was to study the impact of frailty compared with other variables with regards to short-term outcome in the very old ICU population. METHODS: A transnational prospective cohort study from October 2016 to May 2017 with 30 days follow-up was set up by the European Society of Intensive Care Medicine...
September 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#2
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28930140/identification-of-phlogacantholide-c-as-a-novel-adam10-enhancer-from-traditional-chinese-medicinal-plants
#3
Myriam Meineck, Florian Schuck, Sara Abdelfatah, Thomas Efferth, Kristina Endres
Background: Alzheimer's disease is one of the most prevalent dementias in the elderly population with increasing numbers of patients. One pivotal hallmark of this disorder is the deposition of protein aggregates stemming from neurotoxic amyloid-beta peptides. Synthesis of those peptides has been efficiently prevented in AD model mice by activation of an enzyme called alpha-secretase. Therefore, drugs with the capability to increase the expression of this enzyme, named ADAM10, have been suggested as a valuable therapeutic medication...
December 5, 2016: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/28929696/-clinical-analysis-of-cervus-and-cucumis-polypeptide-injection-based-on-real-world-hospital-information-system
#4
Shuai-Ling Sun, Yan-Ming Xie, Yuan-Yuan Li, Yin Zhang, Dan-Hui Yi, Yan Zhuang
To analyze the clinical application of Cervus and Cucumis Polypeptide injection in the real world, in order to define the characteristics of clinical drug use and correlation, and provide reference for risk management and further study for Cervus and Cucumis Polypeptide injection. Descriptive analysis and association rules analysis were performed on 37 721 cases using Cervus and Cucumis Polypeptide injection in 26 hospitals nationwide. Cervus and Cucumis Polypeptide injection were mostly adopted by patients aged between 45 and 64(39...
November 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28927372/potentially-inappropriate-medication-use-in-nursing-homes-an-observational-study-using-the-norgep-nh-criteria
#5
Gunhild Nyborg, Mette Brekke, Jørund Straand, Svein Gjelstad, Maria Romøren
BACKGROUND: Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors. METHODS: Cross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway...
September 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28924446/use-of-intravitreal-dexamethasone-in-a-case-of-anterior-ischemic-optic-neuropathy
#6
Raffaele Nuzzi, Francesca Monteu
Nowadays there is no unique and well-established treatment for nonarteritic anterior ischemic optic neuropathy, despite being the main acute pathology that affects the optic nerve in the elderly population and often resulting in a significant loss of visual acuity. The effectiveness of oral steroids is still under debate in the international literature, although many studies show that patients treated with high doses of systemic corticosteroids have a significantly higher chance of improved visual acuity and visual fields...
May 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28921725/coenzyme-q10-prevents-the-interleukin-1-beta-induced-inflammatory-response-via-inhibition-of-mapk-signaling-pathways-in-rat-articular-chondrocytes
#7
Xing Li, Yuanqing Guo, Shuai Huang, Minhui He, Qiaoli Liu, Weizhi Chen, Minghao Liu, Dongliang Xu, Peiheng He
Preclinical Research Osteoarthritis (OA) is a widely prevalent degenerative joint disease that severely impairs the health of the elderly population resulting in a heavy economic burden worldwide. Coenzyme Q10 (CoQ10) has shown anti-inflammatory effects in some diseases. The present study aimed to investigate if CoQ10 would suppress catabolic responses of interleukin (IL)-1β-induced chondrocytes. Rat chondrocytes were cultured and pretreated with CoQ10, and then stimulated with or without IL-1β (10 ng/ml)...
September 17, 2017: Drug Development Research
https://www.readbyqxmd.com/read/28918484/drug-herb-interactions-in-the-elderly-patient-with-ibd-a-growing-concern
#8
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/28917110/prevalence-and-predictors-of-potentially-inappropriate-prescribing-of-central-nervous-system-and-psychotropic-drugs-among-elderly-patients-a-national-population-study-in-korea
#9
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/28916557/study-of-fall-risk-increasing-drugs-in-elderly-patients-before-and-after-a-bone-fracture
#10
Mónica Beunza-Sola, Ángel M Hidalgo-Ovejero, Jon Martí-Ayerdi, José Germán Sánchez-Hernández, Miguel Menéndez-García, Serafín García-Mata
BACKGROUND: Accidental falls have a significant economic and human impact. The use of certain drugs is one of the modifiable risk factors associated with these events. OBJECTIVE: The aim of this study was to determine the prevalence of use and to explore changes in treatment with fall-related drugs in patients over 65 years of age admitted as a result of a fall-related fracture. METHODS: Observational and prospective study performed in a tertiary level hospital...
September 15, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28915942/development-of-a-validated-lc-ms-ms-method-for-the-quantification-of-19-endogenous-asthma-copd-potential-urinary-biomarkers
#11
Mona M Khamis, Darryl J Adamko, Anas El-Aneed
Obstructive airways inflammatory diseases sometimes show overlapping symptoms that hinder their early and correct diagnosis. Current clinical tests are tedious and are of inadequate specificity in special population such as the elderly and children. Therefore, we are developing tandem mass spectrometric (MS/MS) methods for targeted analysis of urine biomarkers. Recently, proton-nuclear magnetic resonance ((1)H-NMR) analysis proposed 50 urinary metabolites as potential diagnostic biomarkers among asthma and chronic obstructive pulmonary disease (COPD) patients...
October 9, 2017: Analytica Chimica Acta
https://www.readbyqxmd.com/read/28914077/decision-algorithms-for-direct-oral-anticoagulant-use-in-patients-with-nonvalvular-atrial-fibrillation-a-practical-guide-for-neurologists
#12
Isabella Canavero, Giuseppe Micieli, Maurizio Paciaroni
Direct oral anticoagulants (DOACs) are valid alternative options to vitamin K antagonists due to their limited interactions with drugs or food and the fact that they do not require regular coagulation monitoring. To this regard, recent practice guidelines recommend that DOACs should be considered as first-line anticoagulant therapy for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). This review (1) outlines current international guidelines for the management of DOACs to prevent stroke in patients with NVAF, (2) outlines indications for elderly patients as well as specific settings including acute coronary syndromes and intracranial hemorrhage, and (3) offers a practical guide for the use of DOACs in neurological settings...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28905171/pharmacist-intervention-acceptance-for-the-reduction-of-potentially-inappropriate-drug-prescribing-in-acute-psychiatry
#13
Sophia Hannou, Pierre Voirol, André Pannatier, Marie-Laure Weibel, Farshid Sadeghipour, Armin von Gunten, Jean-Frédéric Mall, Isabella De Giorgi Salamun
Background Prescribing for the elderly is challenging. A previous observational study conducted in our geriatric psychiatry admission unit (GPAU) using STOPP/START criteria showed a high number of potentially inappropriate drug prescriptions (PIDPs). A clinical pharmacist was added to our GPAU as a strategy to reduce PIDPs. Objective The objective of the present study was to assess the impact of a clinical pharmacist on PIDPs by measuring acceptance rates of pharmacist interventions (PhIs). Setting This study was conducted at the GPAU of Lausanne University Hospital...
September 13, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28904715/awareness-of-hypertension-and-its-impact-on-blood-pressure-control-among-elderly-nigerians-report-from-the-ibadan-study-of-aging
#14
Yemi Raheem Raji, Taiwo Abiona, Oye Gureje
INTRODUCTION: Hypertension is highly prevalent among the elderly. Its awareness has a direct influence on control through drug adherence. Earlier studies have shown that awareness of hypertension is low among sub-Saharan African populations but only a few studies have looked at the prevalence and awareness of hypertension among the elderly. METHODS: The Ibadan Study of Ageing is a longitudinal cohort study of the mental and physical health status as well as the functioning of elderly persons residing in the Yoruba-speaking areas of Nigeria...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28902678/brief-report-high-need-to-switch-cart-or-comedication-with-the-initiation-of-daas-in-elderly-hiv-hcv-coinfected-patients
#15
Elise J Smolders, Colette Smit, Clara T M M de Kanter, Anton S M Dofferiiof, Joop E Arends, Kees Brinkman, Bart Rijnders, Marc van der Valk, Peter Reiss, David M Burger
BACKGROUND: To describe the use of nonantiretroviral comedication and combination antiretroviral therapy (cART) in patients coinfected with HIV/hepatitis C virus (HCV) and to predict the potential for drug-drug interactions (DDIs) with direct-acting antivirals (DAAs) against HCV. METHODS: This is a retrospective, cross-sectional study, using the Dutch, nationwide ATHENA observational HIV cohort database. All patients with a known HIV/HCV coinfection on January 1, 2015, were included...
October 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28902231/risk-factors-for-the-progression-of-chronic-kidney-disease-after-acute-kidney-injury
#16
Benedito Jorge Pereira, Silvana Barreto, Thais Gentil, Larissa S Assis, Emília Md Soeiro, Isac de Castro, Sandra M Laranja
Introduction: The incidence of chronic kidney disease (CKD) is increasing with the increasing age of the population and the increasing number of elderly survivors of acute kidney injury (AKI). The risk factors for the progression of CKD after AKI are unclear. Objective: To investigate the association between AKI and its progression to CKD and the risk factors involved. Methods: An observational, retrospective study of AKI patients followed from 2009 to 2012 was carried out...
August 28, 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28899369/nursing-care-needs-and-services-utilised-by-home-dwelling-elderly-with-complex-health-problems-observational-study
#17
Gro Næss, Marit Kirkevold, Wenche Hammer, Jørund Straand, Torgeir Bruun Wyller
BACKGROUND: In Norway, as in many Western countries, a shift from institutional care to home care is taking place. Our knowledge is limited regarding which needs for nursing interventions patients being cared for in their home have, and how they are met. We aimed at assessing aspects of health and function in a representative sample of the most vulnerable home-dwelling elderly, to identify their needs for nursing interventions and how these needs were met. METHODS: In this observational study we included patients aged 75+ living in their own homes in Oslo, who received daily home care, had three or more chronic diagnoses, received daily medication, and had been hospitalized during the last year...
September 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28894631/ethnopharmacological-survey-on-traditional-medicinal-plants-at-kalaroa-upazila-satkhira-district-khulna-division-bangladesh
#18
Oby Dulla, Farhana Israt Jahan
AIM: The traditional source of medicinal plants is an important way for daily curative uses in the rural area throughout Bangladesh. An ethnomedicinal survey was conducted in a randomized manner among traditional medicinal practitioners to find out about the medicinal plants of Kalaroa, Bangladesh. MATERIALS AND METHODS: The information was collected through conducting interviews, discussion, and field observations with herbal healers and knowledgeable elders of the study areas from November 01, 2015, to December 31, 2015, who pointed out various medicinal plants and described their uses, using semi-structured questionnaires...
July 2017: Journal of Intercultural Ethnopharmacology
https://www.readbyqxmd.com/read/28894370/reversible-global-aphasia-as-a-side-effect-of-quetiapine-a-case-report-and-literature-review
#19
Ching-Fang Chien, Poyin Huang, Sun-Wung Hsieh
Quetiapine is an atypical antipsychotic agent which is also prescribed for delirium due to its anti-dopaminergic effects; aphasia is an unusual side effect associated with the drug. Here, we report the case of an 83-year-old woman who was prescribed quetiapine (50 mg per day) for delirium. Unexpected, global aphasia occurred 3 days after treatment began. Complete recovery occurred following discontinuation of the drug. A brain computed tomography scan excluded intracranial hemorrhage and the laboratory results confirmed that no exacerbation of infection or electrolyte imbalances were present...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28894183/gut-microbiota-composition-is-associated-with-polypharmacy-in-elderly-hospitalized-patients
#20
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
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