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https://www.readbyqxmd.com/read/20922432/risperidone-induced-bulbar-palsy-like-syndrome
#1
Jason Jonathon Sico, Huned Patwa
There have been several case reports of risperidone-associated dysphagia. Risperidone-induced bulbar palsy-like syndrome has not been previously described. We report on a 58-year-old gentleman with prior history of schizophrenia and remote chlorpromazine use with no history of extrapyramidal symptoms who experienced acute onset of dysphagia and facial diplegia with hyperprolactinemia while being treated with risperidone. To date there have been five reported cases of dysphagia associated with risperidone, occurring by such mechanisms as isolated pharyngeal dysfunction from pharyngeal constrictor palsy and dystonia, drug-induced parkinsonism, and acute dystonic reaction...
September 2011: Dysphagia
https://www.readbyqxmd.com/read/28740372/pharmacological-treatment-of-osteoporosis-in-the-oldest-old
#2
REVIEW
A Vandenbroucke, F P Luyten, J Flamaing, E Gielen
The incidence of osteoporotic fractures increases with age. Consequently, the global prevalence of osteoporotic fractures will increase with the aging of the population. In old age, osteoporosis is associated with a substantial burden in terms of morbidity and mortality. Nevertheless, osteoporosis in old age continues to be underdiagnosed and undertreated. This may, at least partly, be explained by the fact that evidence of the antifracture efficacy of osteoporosis treatments comes mainly from randomized controlled trials in postmenopausal women with a mean age of 70-75 years...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28692142/big-g-and-little-g-geriatrics-education-for-physicians
#3
Kathryn E Callahan, Nina Tumosa, Rosanne M Leipzig
In the July 2016 issue of this journal, Dr. Mary Tinetti proposed that geriatric medicine abandon attempts to increase the numbers of board-certified geriatricians and change focus to the development of a "small elite workforce." What would be gained and what sacrificed by accepting this challenge? We agree that the best clinical use of a scarce resource, specialty trained geriatricians, is to care for frail, complex, severely ill elderly adults and to help design and study novel interventions in research, education, and care models to improve the care of all older adults, but for this to happen, all other providers must attain specific competency in the care of older adults...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28258535/routine-use-of-budesonide-formoterol-fixed-dose-combination-in-elderly-asthmatic-patients-practical-considerations
#4
REVIEW
Nicola Scichilone, Fulvio Braido, Federico Lavorini, Mark L Levy, Omar S Usmani
Asthma has been demonstrated to be as common in the elderly as in younger age groups. Although no specific recommendations exist to manage the disease differently in older individuals, functional features and clinical presentations may be affected by age per se, and by age-related conditions, such as comorbidities and polypharmacy. In this review article, we aimed to explore the efficacy and safety in elderly asthmatic patients of one of the most currently used inhaled treatments for asthma, that is, the fixed-dose combination of budesonide/formoterol...
May 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28303369/clinical-aspects-of-changes-in-water-and-sodium-homeostasis-in-the-elderly
#5
REVIEW
Christian A Koch, Tibor Fulop
The population of elderly individuals is increasing worldwide. With aging, various hormonal and kidney changes occur, both affecting water homeostasis. Aging is a risk factor for chronic kidney disease (CKD) and many features of CKD are reproduced in the aging kidney. Dehydration and hyperosmolarity can be triggered by diminished thirst perception in this population. Elderly with dementia are especially susceptible to abnormalities of their electrolyte and body water homeostasis and should be (re-)assessed for polypharmacy...
March 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28472333/aging-and-the-ethics-of-authenticity
#6
Hanne Laceulle
This article aims to make a philosophical contribution to debates about meaningful sociocultural narratives about aging. It is argued that the moral-philosophical discourse of authenticity may provide valuable resources for counter narratives about later life that are capable of challenging the dominant stereotyping decline- and age-defying cultural narratives. The discussion will draw on classical and contemporary views of authenticity by Rousseau; existentialists such as Kierkegaard, Nietzsche, and Heidegger; and contemporary thinkers such as Taylor and Meyers...
May 2, 2017: Gerontologist
https://www.readbyqxmd.com/read/28535241/management-of-depression-in-older-adults-a-review
#7
REVIEW
Rob M Kok, Charles F Reynolds
Importance: Depression in older adults is a common psychiatric disorder affecting their health-related quality of life. Major depression occurs in 2% of adults aged 55 years or older, and its prevalence rises with increasing age. In addition, 10% to 15% of older adults have clinically significant depressive symptoms, even in the absence of major depression. Observations: Depression presents with the same symptoms in older adults as it does in younger populations...
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/20375886/adrenal-insufficiency-etiology-diagnosis-and-treatment
#8
REVIEW
Nicola Neary, Lynnette Nieman
PURPOSE OF REVIEW: Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2010 because of its lethal nature. RECENT FINDINGS: Reports illuminate features of adrenal insufficiency cause, diagnosis and treatment, and the role of glucocorticoids in critical illness. SUMMARY: Progress has been made in identifying human leukocyte antigen and major histocompatability complex alleles that predispose to the development of adrenal insufficiency in patients with antibodies to 21-hydroxylase, but their role in clinical care is not established...
June 2010: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/27986133/prevention-and-management-of-glucocorticoid-induced-side-effects-a-comprehensive-review-gastrointestinal-and-endocrinologic-side-effects
#9
REVIEW
Avrom Caplan, Nicole Fett, Misha Rosenbach, Victoria P Werth, Robert G Micheletti
Part 2 of this 4-part continuing medical education series continues with a discussion of the prevention and management of gastrointestinal side effects associated with corticosteroid use, including peptic ulcer disease, gastrointestinal bleeding, and pancreatitis, followed by a review of corticosteroid-related endocrinologic side effects, such as diabetes, adrenal suppression, and Cushing syndrome.
January 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/22171584/clinically-significant-drug-interactions-with-newer-antidepressants
#10
REVIEW
Edoardo Spina, Gianluca Trifirò, Filippo Caraci
After the introduction of selective serotonin reuptake inhibitors (SSRIs), other newer antidepressants with different mechanisms of action have been introduced in clinical practice. Because antidepressants are commonly prescribed in combination with other medications used to treat co-morbid psychiatric or somatic disorders, they are likely to be involved in clinically significant drug interactions. This review examines the drug interaction profiles of the following newer antidepressants: escitalopram, venlafaxine, desvenlafaxine, duloxetine, milnacipran, mirtazapine, reboxetine, bupropion, agomelatine and vilazodone...
January 1, 2012: CNS Drugs
https://www.readbyqxmd.com/read/22732295/treatment-of-four-psychiatric-emergencies-in-the-intensive-care-unit
#11
REVIEW
O Joseph Bienvenu, Karin J Neufeld, Dale M Needham
OBJECTIVES: To review the diagnosis and management of four selected psychiatric emergencies in the intensive care unit: agitated delirium, neuroleptic malignant syndrome, serotonin syndrome, and psychiatric medication overdose. DATA SOURCES: Review of relevant medical literature. DATA SYNTHESIS: Standardized screening for delirium should be routine. Agitated delirium should be managed with an antipsychotic and, possibly, dexmedetomidine in treatment-refractory cases...
September 2012: Critical Care Medicine
https://www.readbyqxmd.com/read/19001785/clinical-value-of-automatic-reporting-of-estimated-glomerular-filtration-rate-in-geriatrics
#12
Hanife Kurtal, Vedat Schwenger, Marina Azzaro, Nadja Abdollahnia, Elisabeth Steinhagen-Thiessen, Rolf Nieczaj, Ralf-Joachim Schulz
BACKGROUND: Geriatric patients frequently have impaired renal function. Multimorbidity leads to polypharmacy with high risk of adverse drug reactions. OBJECTIVE: The aim was to evaluate the prevalence of renal impairment and risk of overdosing renally excreted drugs in hospitalized geriatric patients. METHODS: In 221 patients aged >or=65 years, GFR was estimated by the MDRD, Cockcroft-Gault (CG) and lean body mass (LBM)-adjusted CG equations...
2009: Gerontology
https://www.readbyqxmd.com/read/10803857/differential-pharmacokinetics-of-lithium-in-elderly-patients
#13
REVIEW
B A Sproule, B G Hardy, K I Shulman
The pharmacotherapeutic use of lithium in the elderly as acute and maintenance therapy in bipolar disorder and augmentation therapy for major depression is well documented. Differences in the response to lithium are explained, in part, by the effect of age-related physiological changes, comorbid conditions, and concurrent medications on the pharmacokinetics of lithium in the elderly. The pharmacokinetic profile of lithium has been studied for many years, primarily in younger adult populations. Lithium pharmacokinetics may be influenced by a number of factors including age...
March 2000: Drugs & Aging
https://www.readbyqxmd.com/read/28323335/surgical-guidelines-for-perioperative-management-of-older-adults-what-geriatricians-need-to-know
#14
Jessica L Colburn, Sanjay Mohanty, John R Burton
A multidisciplinary panel of experts representing surgery, anesthesia, and geriatrics recently published guidelines for surgeons on the optimal perioperative management of older adults, including recommendations on postoperative recovery and posthospital transitions of care. Geriatricians have an important role in the care for older adults in the preoperative period as older adults consider surgical options and prepare for surgical procedures, during the perioperative period as inpatient consultants, and in the postoperative period as older adults transition to rehabilitation facilities or to home...
June 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28329788/defining-health-trajectories-in-older-adults-with-five-clinical-indicators
#15
Giola Santoni, Alessandra Marengoni, Amaia Calderón-Larrañaga, Sara Angleman, Debora Rizzuto, Anna-Karin Welmer, Francesca Mangialasche, Nicola Orsini, Laura Fratiglioni
Background: People age differently, challenging the identification of those more at risk of rapid health deterioration. This study aimed to explore the heterogeneity in the health of older adults by using five clinical indicators to detect age-related variation and individual health trajectories over time. Methods: Health of 3,363 people aged 60+ from the Swedish National study on Aging and Care-Kungsholmen (SNAC-K) assessed at baseline and at 3- and 6-year follow-ups...
August 1, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/4054193/cns-related-side-effects-with-metoprolol-and-atenolol
#16
RANDOMIZED CONTROLLED TRIAL
J R Cove-Smith, C A Kirk
Vivid and bizarre dreams, hallucinations, sleep disturbance and psychosis have all been described following treatment with beta-blockers. It has been suggested that these central nervous system (CNS) side-effects are related to the degree of lipophilicity of the beta-blocker. A randomized double-blind crossover study was performed to compare the incidence of CNS side-effects with atenolol and metoprolol in hypertensive patients who had reported CNS side-effects with lipophilic beta-blockers. Eleven women and six men completed the study, in which a 30-item psychiatric questionnaire was used to detect changes in psychological status and possible CNS side-effects...
1985: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28282301/postoperative-confusion-in-older-adults
#17
Freddi Segal-Gidan
The development of postoperative confusion in older patients is increasingly being recognized as clinically significant because it is becoming more common as the population ages. Postoperative delirium and postoperative cognitive dysfunction differ in time course of development. Risk factors other than age include certain medications as well as anesthesia (both the type and amount used). Postoperative delirium and postoperative cognitive dysfunction appear to increase a patient's risk for developing dementia...
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28262178/zolpidem-s-use-for-insomnia
#18
REVIEW
Jaime M Monti, David Warren Spence, Kenneth Buttoo, Seithikurippu R Pandi-Perumal
Zolpidem is a short-acting non-benzodiazepine hypnotic drug that belongs to the imidazopyridine class. In addition to immediate-release (IR) and extended-release (ER) formulations, the new delivery forms including two sublingual tablets [standard dose (SD) and low dose (LD)], and an oral spray form have been recently developed which bypass the gastrointestinal tract. So far, Zolpidem has been studied in several clinical populations: cases poor sleepers, transient insomnia, elderly and non-elderly patients with chronic primary insomnia, and in comorbid insomnia...
February 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/12090909/acute-delirium-induced-by-metoprolol
#19
Alexander A Fisher, Michael Davis, Ian Jeffery
OBJECTIVE: To describe a case of delirium associated with use of metoprolol and to analyse 24 such cases including 22 cases reported to Australian Adverse Drug Reaction Advisory Committee and one case previously published (S. Ahmad, Am Fam Physician, 1991;44:1142, 1144). CASE SUMMARY: An 89 year old caucasian man with an acute coronary syndrome who had no psychiatric history and no infections, brain injury, stroke, metabolic nor neoplastic disease developed delirium after two small doses of metoprolol (25 mg)...
March 2002: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/22336000/metoprolol-induced-visual-hallucinations-a-case-series
#20
Jonathan A Goldner
INTRODUCTION: Metoprolol is a widely used beta-adrenergic blocker that is commonly prescribed for a variety of cardiovascular syndromes and conditions. While central nervous system adverse effects have been well-described with most beta-blockers (especially lipophilic agents such as propranolol), visual hallucinations have been only rarely described with metoprolol. CASE PRESENTATIONS: Case 1 was an 84-year-old Caucasian woman with a history of hypertension and osteoarthritis, who suffered from visual hallucinations which she described as people in her bedroom at night...
February 15, 2012: Journal of Medical Case Reports
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