364 results on '"Geriatric pharmacology"'
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2. The Importance of Drug Dose Adjustment in Elderly Patients with Special Considerations for Patients on Diverse Co-medications and Antidepressants
- Author
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Bhaskar, Manju, Telessy, Istvan G., Buttar, Harpal S., Sobti, R.C., editor, and Dhalla, Naranjan S., editor
- Published
- 2022
- Full Text
- View/download PDF
3. Optimizing Pharmacotherapy in Older Patients : An Interdisciplinary Approach
- Author
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Antonio Cherubini, Arduino A. Mangoni, Denis O’Mahony, Mirko Petrovic, Antonio Cherubini, Arduino A. Mangoni, Denis O’Mahony, and Mirko Petrovic
- Subjects
- Geriatric pharmacology
- Abstract
This book summarizes the broad and rapidly evolving field of geriatric pharmacotherapy, which is becoming increasingly relevant for practicing physicians who care and prescribe medications for older patients. Around the globe, ageing populations are associated with an increased prevalence of chronic diseases. Older adults are often affected by multimorbidity, i.e., suffer from more than one chronic disease. The main consequence of multimorbidity is polypharmacy, which is commonly defined as the regular use of five or more medicines. Polypharmacy has now reached epidemic proportions in our societies, and is associated with an increased risk of drug-drug interactions, drug-disease interactions and adverse drug reactions. The management of polypharmacy in older patients with complex multimorbidity poses several challenges and needs to be based on specific knowledge and prescribing expertise.The aim of this book is to provide a comprehensive update on thefield, and to share the expertise needed to optimize the management of pharmacotherapy in older patients.
- Published
- 2023
4. Maybe It's Your Medications : How to Avoid Unnecessary Drug Therapy and Adverse Drug Reactions
- Author
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Hedva Barenholtz Levy and Hedva Barenholtz Levy
- Subjects
- Drugs--Side effects, Geriatric pharmacology
- Abstract
Adults ages 65+: Your medication could be the reason for your new medical condition; read this eye-opening guide to become an expert on what medications you take!We have a medication problem in America. It is marked not only by excessive use of medications, but by errors in how they are prescribed, monitored, and taken. An estimated nineteen million adults age sixty-five and older take five or more medications daily. These individuals and family caregivers know the frustrations of lengthy medication lists, high drug costs, and frequent questions about the need and value of those medications. All too often, an unrecognized adverse drug effect is mistaken for a new medical condition, or worse, a symptom of getting older. But who stops to question the medications?Maybe It's Your Medicationstackles these problems by providing information, insider tips, and strategies that empower patients and caregivers to have important conversations about their prescription and nonprescription drugs. This book addresses the questions consumers want to ask about their medications and brings to light other questions they should be asking but may not know how. It is everyone's go-to guide on how to use medications safely on the journey to healthy aging. Dr. Hedva Barenholtz Levy, PharmD, is a geriatric specialist and founder of a unique senior care practice of over 25 years working with patients in their homes. She is an educator and leader in geriatric pharmacy and a dual board-certified specialist. Dr. Levy applies her decades of experience to guide the reader in how to become an active participant on their healthcare team and prevent unintended errors and medication-related problems.
- Published
- 2023
5. Pain in the Elderly
- Author
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To, Lisa and Noe, Carl Edward, editor
- Published
- 2020
- Full Text
- View/download PDF
6. Anti-Aging Pharmacology
- Author
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Vitaly Koltover and Vitaly Koltover
- Subjects
- Geriatric pharmacology, Aging--Health aspects, Aging--Prevention
- Abstract
Anti-Aging Pharmacology provides an overview of current research aimed at the pharmacological modulation of aging, including a discussion of the growing number of novel drug classes with promising anti-aging potential. The aging process is the main risk factor for all chronic diseases affecting the elderly. With lifespans extending across the globe, these chronic diseases are placing a larger burden on individuals and health care systems. Therefore, slowing down the aging rate could be more effective in delaying aging-associated chronic disorders than combating them one by one, which is the conventional approach in a current disease-based pharmacological paradigm. This book contains the work of the world's leading researchers in the field, including sections on the conceptual and methodological background of anti-aging pharmacology, the basic classes of anti-aging drugs, phytochemicals, outcomes of anti-aging developments and future directions. This book will be of interest to a wide audience, ranging from pharmacologists, medicinal chemists and academic researchers in gerontology, biomedical sciences and those in medical practice. - Includes updated information about current developments in anti-aging pharmacology - Offers practical advice on the applicability of certain healthspan-promoting medications - Discusses potential challenges related to the translation of anti-aging drugs in clinical practice
- Published
- 2022
7. Alternativen zum Psychopharmakaeinsatz in Senioreneinrichtungen
- Author
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Renate Wittig and Renate Wittig
- Subjects
- Drugs--Prescribing--Corrupt practices, Psychotropic drugs, Geriatric pharmacology, Older people--Drug use
- Abstract
Der Einsatz von Psychopharmaka in Senioreneinrichtungen in Deutschland steht seit Jahren in der Kritik – oftmals würden sie nur zur Ruhigstellung, nicht aber aus medizinischen Gründen verordnet. Renate Wittig hat für ihre hier vorgelegte Studie anhand von Daten der AOK-Versicherten die Verordnung von Psychopharmaka in den Jahren 2010 bis einschließlich 2014 mit Blick auf alters- und geschlechtsspezifische Besonderheiten analysiert. Ein besonderes Interesse galt dabei der Frage, in welcher Pflegestufe sich diese Patienten während des Einnahmezeitraumes befanden und ob es sich um Bewohner einer Pflegeeinrichtung handelte. Entgegen den Erwartungen erfolgten die meisten Psychopharmaka-Verordnungen für Patienten der Pflegestufe 0. Gerade für diese wäre ein Ausweichen auf andere Therapiemöglichkeiten und -optionen und Interventionen durchaus möglich, hilfreich und sinnvoll. In der Altersklasse von 70 bis 75 Jahre sind für die männlichen und in der Altersklasse von 75 bis 80 Jahre für die weiblichen Versicherten die höchsten Verordnungszahlen gefunden worden. Gesondert betrachtet wurden die Psycholeptika-Verordnungen der AOK-Versicherten im Zeitraum von 2010 bis 2015. Im Fokus standen dabei insbesondere Benzodiazepin- und Antidepressiva-Verordnungen. Obwohl durch Studien belegt ist, dass deren Einnahme über einen Zeitraum von mehr als 3 Monaten das Risiko, an einer Alzheimer-Demenz zu erkranken, um rund fünfzig Prozent steigert, werden Benzodiazepine besonders in der Altersklasse der 70- bis 80-Jährigen noch immer in hohem Ausmaße verordnet. Über die Analyse hinaus gibt Wittig einen Abriss über den Einfluss von Psychopharmaka auf kognitive Fähigkeiten und belegt unter Bezugnahme auf bereits vorhandene Studien, dass verschiedene alternative Wege möglich sind, den Alltag von an Demenz oder Depression erkrankten Senioren durch nichtmedikamentöse Interventionen wesentlich zu erleichtern. Dabei geht es vor allem darum, die Lebensqualität zu steigern und die Alltagskompetenz zu erhöhen. Wittig stellt geeignete Trainingsprogramme für Senioren zur Steigerung der physischen und kognitiven Leistungsfähigkeit vor und bewertet sie. Das Buch richtet sich insbesondere an die Leitungen von Senioreneinrichtungen, an Pflegedienstleitungen und heimversorgende Apotheken, aber auch an Ärzte, die Pflegeheime betreuen, sowie an Betroffene und Interessierte im Bereich der Pflege. Sowohl die Bewohner dieser Einrichtungen als auch das Pflegepersonal würden unmittelbar von einer Berücksichtigung und Umsetzung der hier präsentierten Ergebnisse profitieren.
- Published
- 2019
8. Delivery of Therapeutics for Biogerontological Interventions : From Concepts to Experimental Design
- Author
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Wing-Fu Lai and Wing-Fu Lai
- Subjects
- Life expectancy, Drug delivery systems, Geriatric pharmacology
- Abstract
Delivery of Therapeutics for Biogerontological Interventions: From Concepts to Experimental Design provides tactics on how to facilitate planning and research in interventive biogerontology. The book helps create clearer directions for the translation of existing advances in delivery technologies, from lab to practice. It is ideal as a starting point for scientists, clinicians and those interested in the field of biogerontology, biomedicine or nanotechnology, comprehensively discussing how to translate bench works to practicable tactics that retard the aging process. Using support from recent advances reported in literature, this title takes advantage of delivery technologies to develop biogerontological interventions, from concept to experimental design. - Provides the first comprehensive reference to guide researchers through the process of intervention development, from concepts, to practicable interventions - Covers the information needed to exploit the use of delivery technologies in intervention biogerontology - Presents complete coverage of advances in the field, all of which are supported by full color photographs, figures and references
- Published
- 2019
9. Polypharmacy Results in Functional Impairment in Mice: Novel Insights Into Age and Sex Interactions.
- Author
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Wu, Harry, Mach, John, Gemikonakli, Gizem, Tran, Trang, Allore, Heather, Gnjidic, Danijela, Howlett, Susan E, Cabo, Rafael de, Couteur, David G Le, Hilmer, Sarah N, de Cabo, Rafael, and Le Couteur, David G
- Subjects
- *
POLYPHARMACY , *LABORATORY mice , *PHYSICAL mobility , *WALKING speed , *GRIP strength - Abstract
Males and females may respond differently to medications, yet knowledge about sexual dimorphisms in the effects of polypharmacy remains limited, particularly in aging. This study aimed to assess the effect of high Drug Burden Index (DBI) polypharmacy treatment compared to control on physical function and behavior in young and old, male and female mice. We studied whether age and sex play a role in physical function and behavior following polypharmacy treatment and whether they are paralleled by differences in serum drug levels. Young (2.5 months) and old (21.5 months), C57BL/6 mice were randomized to control or high DBI polypharmacy treatment (simvastatin, metoprolol, oxybutynin, oxycodone, and citalopram; n = 6-8/group) for 4-6 weeks. Compared to control, polypharmacy reduced physical function (grip strength, rotarod latency, gait speed, and total distance), middle zone distance (increased anxiety), and nesting score (reduced activities of daily living) in mice of both ages and sexes (p < .001). Old animals had a greater decline in nesting score (p < .05) and midzone distance (p < .001) than young animals. Grip strength declined more in males than females (p < .05). Drug levels at steady state were not significantly different between polypharmacy-treated animals of both ages and sexes. We observed polypharmacy-induced functional impairment in both age and sex groups, with age and sex interactions in the degree of impairment, which were not explained by serum drug levels. Studies of the pathogenesis of functional impairment from polypharmacy may improve management strategies in both sexes. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
10. Medikamentenmanagement in der ambulanten und stationären Altenpflege : Mehr Sicherheit für Pflegemitarbeiter und Patient
- Author
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Kirstin Göttel and Kirstin Göttel
- Subjects
- Geriatric pharmacology
- Abstract
Die gewissenhafte und sorgfältige Organisation der Medikamentenversorgung ist eine sehr verantwortungsvolle Aufgabe. Zum Medikamentenmanagement gehört nicht nur das Verabreichen der Medikamente, sondern auch die Entgegennahme der ärztlichen Verordnung, die Beschaffung, Vorbereitung und Dokumentation der Medikamente sowie die Beobachtung des Patienten auf Wirkungen und Nebenwirkungen. Das Taschenbuch vermittelt Kenntnisse über den gesamten Steuerungsprozess und die notwendigen Vorgaben zum Umgang mit Medikamenten in der Altenpflege, wie diese von den Prüfinstanzen (Heimaufsicht und MDK) abverlangt werden. Hinzu kommen fachliche und rechtliche Informationen über Verabreichung von Medikamenten. Fallbeispiele, Checklisten und Praxistipps unterstützen dabei, Fehlerquellen in der Medikamentengabe zu vermeiden.
- Published
- 2018
11. Chronic Polypharmacy with Increasing Drug Burden Index Exacerbates Frailty and Impairs Physical Function, with Effects Attenuated by Deprescribing, in Aged Mice.
- Author
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Mach, John, Gemikonakli, Gizem, Logan, Caitlin, Wyk, Brent Vander, Allore, Heather, Ekambareshwar, Swathi, Kane, Alice E, Howlett, Susan E, Cabo, Rafael de, Couteur, David G Le, and Hilmer, Sarah N
- Subjects
- *
PHYSICAL mobility , *POLYPHARMACY , *OLD age , *MICE - Abstract
Polypharmacy (use of ≥5 medications) and increasing Drug Burden Index (DBI) score (measure of person's total exposure to anticholinergic/sedative medications) are associated with impaired physical function in observational studies of older adults. Deprescribing, the supervised withdrawal of medications for which harms outweigh benefits for an individual, may be a useful intervention. Current knowledge is limited to clinical observational studies that are unable to determine causality. Here, we establish a preclinical model that investigates the effects of chronic polypharmacy, increasing DBI, and deprescribing on global health outcomes in aging. In a longitudinal study, middle-aged (12 months) male C57BL/6J (B6) mice were administered control feed or feed and/or water containing polypharmacy or monotherapy with different DBI scores. At 21 months, each treatment group was subdivided (stratified by frailty at 21 months) to either continue on treatment for life or to have treatment withdrawn (deprescribed). Frailty and physical function were evaluated at 12, 15, 18, and 24 months, and were analyzed using a mixed modeling approach. Polypharmacy with increasing DBI and monotherapy with citalopram caused mice to become frailer, less mobile, and impaired their strength and functional activities. Critically, deprescribing in old age reversed a number of these outcomes. This is the first preclinical study to demonstrate that chronic polypharmacy with increasing DBI augments frailty and impairs function in old age, and that drug withdrawal in old age reversed these outcomes. It was not the number of drugs (polypharmacy) but the type and dose of drugs (DBI) that caused adverse geriatric outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
12. Geriatric Pharmacology : The Principles of Practice & Clinical Recommendation, Second Edition
- Author
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Steven Atkinson and Steven Atkinson
- Subjects
- Pharmacology, Geriatric pharmacology
- Abstract
Now in its second edition, Geriatric Pharmacology: The Principles of Practice & Clinical Recommendations is the optimal guide for anyone seeking straightforward, concise and user-friendly information on medication dynamics for older adults. Fully revised and updated, this invaluable resource has become the go-to favorite for healthcare professionals.Here's what you'll find:Learn to manage medication combinations without causing harmHow to safely prescribe opioidsAvoiding the top 10 most dangerous geriatric drugsPractical guidelines to stop and start prescriptionsDrug-drug interaction charts and strategies
- Published
- 2016
13. Arzneitherapie für Ältere
- Author
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Martin Wehling, Heinrich Burkhardt, Martin Wehling, and Heinrich Burkhardt
- Subjects
- Geriatrics, Geriatric pharmacology
- Abstract
Dieses Buch bietet sichere Arzneitherapie für ältere Patienten und wendet sich mit den folgenden Fragestellungen an die Fachärzte.Welche Besonderheiten es bei älteren Patienten gibt Welche Nebenwirkungen/Wechselwirkungeninsbesondere beachtet werden müssen und ggfs. als neue eigenständige Erkrankungen fehlinterpretiert werden könnenWelche Arzneimittel für ältere Patienten ungeeignet sind bzw. besondere Vorsicht erfordernMenschen im Alter über 65 Jahre bilden die am stärksten wachsende Bevölkerungsgruppe.Ältere Patienten haben häufig mehrere - oft chronische – Erkrankungen. Unerwünschte Arzneimittelwirkungen sind überdurchschnittlich häufig u.a. wegen:geänderter biologischer Eckdaten (Leberdurchblutung und Nierenfunktion vermindert, mehr Fett- weniger Muskelmasse)mangelnder Compliance Vielfachmedikation mit kaum vorhersagbaren Wechselwirkungen NEUNeueste Daten, Statistiken, Key EvidencesWertungssystem für Alterstauglichkeit von Arzneimitteln nach FORTA-Liste (top-aktuell nach 2. Delphi-Prozess 2015)Neue Inhalte, u.a.SuchterkrankungenWechselwirkungen von Medikamenten mit Lebensmitteln (z.B. Grapefruit) oder mit pflanzlichen Arzneimitteln (z.B. Johanniskrautpräparate).Choosing wiselyDie Lösungsvorschläge und Antworten für die tägliche Praxis: Medizinische Sicherheit: Welche Medikamente haben Priorität? Was kann/muss ich weglassen? Ökonomische Sicherheit: Bessere Arzneitherapie mit weniger Verschreibungen (= Einhaltung des Arzneimittelbudgets).
- Published
- 2016
14. Improving Medication Management in Home Care : Issues and Solutions
- Author
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Dennee Frey and Dennee Frey
- Subjects
- Older people--Home care, Home care services--Quality control, Geriatric pharmacology, Medication errors--Prevention, Older people--Drug use
- Abstract
Help stop the widespread problem of medication errors among the elderly The problem of medication errors among the elderly is widespread. Improving Medication Management in Home Care: Issues and Solutions tackles this tough issue by closely examining the challenges faced in preventing medication errors in home and community care program settings and putting forth effective solutions to better manage medication use. Respected experts discuss the unique role of the pharmacist in improving patient safety, presenting a comprehensive collection of evidence-based studies featuring national and international viewpoints, cutting-edge interventions, and cost-effective procedures that address medication problems in older adults.Polypharmacy is the term used for patients receiving too many medications for a specific treatment. The implications for drug-drug interactions can be dangerous for the unaware patient. Improving Medication Management in Home Care: Issues and Solutions focuses on several different effective management programs and examines each in detail, completely explaining the positiveand negativeresults. This hands-on practical information is useful for all professionals and field providers working with older adults and their medication concerns. The book also provides valuable lessons through the experiences of national home health leaders in various settingshospital-based, rural, large or small, etc., as well as community-based programs for dually eligable older adults. The book is extensively referenced and includes an abundance of clear, helpful tables, figures, and Web resources.Improving Medication Management in Home Care: Issues and Solutions explores: developing computerized risk assessment screenings implementing pharmacist-centered interventions improving transitional care from hospital to home the Prescription Intervention and Lifelong Learning (PILL) program Medication Therapy Management Services a quality-improvement project to reduce falls and improve medication management outcome-based quality improvement for patient safety intern programs that can provide cost-effective consultant services Improving Medication Management in Home Care: Issues and Solutions is essential reading for home health care administrators, clinicians, managers, pharmacists, physicians, educators, students, those professionals involved in the field of aging, and health practitioners world-wide.
- Published
- 2016
15. Optimization of Drug Prescribing in Elderly
- Author
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Olguín, Hugo Juárez, Lares Asseff, Ismael, Olguín, Hugo Juárez, and Lares Asseff, Ismael
- Subjects
- Chemotherapy, Scheduling, Geriatric pharmacology, Older people
- Abstract
The present book offers a set of chapters which describes the procedure for drug treatment of the principal diseases that older people suffer from. In the pharmacological concept, it has been established that pharmacokinetics is the most useful strategy to determine the prime schedule of different medications for seniors. These strategies can be applied in a clinic or nursing home as well as in a home. The initial chapter describes optimizing this technique, continuing with a description of the most common illnesses due to old age. The next chapter discusses deep concepts of pharmacokinetics. Afterwards, some examples of pharmacokinetics studies are described. The text finishes with a description based on previous studies about the patterns of drug consumption in older individuals. The authors hope this material can be useful first to aid the elderly population and can motivate the investigation of pharmacokinetic studies, since this material is lacking in the global context.
- Published
- 2016
16. پیچیدگیهای فارماکولوژی سالمندان مدیریت چالشهای دارویی در جمعیت سالمند.
- Author
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شادی سرهرودی
- Subjects
MEDICAL sciences ,GERIATRIC pharmacology ,AGING - Abstract
Introduction: Geriatric pharmacology, the branch of medical science concerned with the study of drugs and their effects on the elderly, is an intricate field that warrants meticulous investigation. The physiology of older adults undergoes significant alterations, leading to a myriad of challenges when managing medication regimens. For example, the aging process diminishes the liver and kidney functions, which are crucial for metabolizing and eliminating drugs. Consequently, older adults are often more susceptible to adverse drug reactions and interactions. Additionally, the elderly commonly have multiple comorbidities, necessitating polypharmacy, which involves the concurrent use of several medications. Polypharmacy increases the likelihood of drug-drug interactions and complicates medication management. Methods and Materials: Patient education is an essential component in addressing these challenges. Ensuring that these patients are well-informed about their medications may facilitate adherence and reduce errors. Moreover, healthcare professionals should prioritize deprescribing, which entails the systematic discontinuation of medications that are no longer necessary or beneficial. This practice can minimize the risks associated with polypharmacy. Results: Another significant concern is the potential underrepresentation of the elderly in clinical trials. These studies often exclude older adults, particularly those with multiple comorbidities. This underrepresentation can lead to a lack of understanding of how medications affect this demographic, further complicating geriatric pharmacology. Conclusion: In conclusion, geriatric pharmacology is a complex field due to physiological changes associated with aging and the challenges posed by polypharmacy. Patient education, deprescribing, and ensuring the inclusion of the elderly in clinical trials are essential strategies for navigating medication challenges in aging populations. Through a concerted effort among patients, caregivers, and healthcare professionals, we can work towards optimizing medication management for the elderly. [ABSTRACT FROM AUTHOR]
- Published
- 2023
17. Reports on Immunology Findings from Sichuan Agricultural University Provide New Insights (Therapeutic application of quercetin in aging-related diseases: SIRT1 as a potential mechanism)
- Subjects
Quercetin -- Health aspects ,Aging -- Health aspects ,Geriatric pharmacology ,Health - Abstract
2022 AUG 13 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on immunology. According to news originating from Chengdu, [...]
- Published
- 2022
18. First Affiliated Hospital of Nanjing Medical University Researchers Further Understanding of Acute Coronary Syndrome (Performance of PRECISE-DAPT and Age-Bleeding-Organ Dysfunction Score for Predicting Bleeding Complication During Dual ...)
- Subjects
Hemorrhage -- Complications and side effects -- Drug therapy ,Geriatric pharmacology ,Blood platelets -- Aggregation ,Health - Abstract
2022 JUL 30 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New research on acute coronary syndrome is the subject of a new [...]
- Published
- 2022
19. Studies from Sorbonne University Reveal New Findings on COVID-19 (Corticosteroid Therapy In Covid-19 Associated With In-hospital Mortality In Geriatric Patients: a Propensity Matched Cohort Study)
- Subjects
Corticosteroids -- Testing ,Geriatric pharmacology ,Health - Abstract
2022 JUN 18 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in Coronavirus - COVID-19. According to news reporting [...]
- Published
- 2022
20. New Findings from Beth Israel Deaconess Medical Center Describe Advances in Hypertension (National Trends In Antihypertensive Treatment Among Older Adults By Race and Presence of Comorbidity, 2008 To 2017)
- Subjects
Geriatric pharmacology ,Antihypertensive drugs -- Testing -- Physiological aspects ,Health - Abstract
2022 JUN 4 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Research findings on Cardiovascular Diseases and Conditions - Hypertension are discussed in [...]
- Published
- 2022
21. Fundamentals of Geriatric Pharmacotherapy
- Author
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Lisa C. Hutchison, Rebecca B. Sleeper, Lisa C. Hutchison, and Rebecca B. Sleeper
- Subjects
- Older people, Chemotherapy, Geriatric pharmacology
- Abstract
As the number of older patients surge, so too will the medication management challenges pharmacists and other healthcare providers face with this population. Providing care for these often complex cases means not only staying on top of new medications and therapies, but dealing with a wide range of other issues as well. Now in its second edition, Fundamentals of Geriatric Pharmacotherapy, by Lisa C. Hutchison and Rebecca B. Sleeper, offers the full support you need to provide the most effective medication management and therapeutic decisions. This text is unique, not only as a comprehensive overview of major issues in geriatric pharmacotherapy and a core textbook for students, but as a resource for all healthcare professionals who treat elderly patients. Covering all major topics and issues, the second edition provides the most current information and proven strategies in one comprehensive guide, including associated issues that impact therapy, such as the coordination of care across multiple venues and caregivers. Inside this edition, you will find: Summarized treatment guidelines Evidence-based reviews Recommendations for the frail elderly Case studies and clinical pearls Key points, terms, and definitions Self-assessment questions Extensively referenced New chapters on Palliative and Hospice Care and Infections and Antimicrobial Stewardship The demands of an aging population mean that a greater understanding of geriatric pharmacotherapy is now essential for all healthcare providers. Written by practicing geriatric specialists, Fundamentals of Geriatric Pharmacotherapy provides all the detailed information and practical guidance you need.
- Published
- 2015
22. Preferences and attitudes of older adults of Bialystok, Poland toward the use of over-the-counter drugs
- Author
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Cybulski M, Cybulski L, Krajewska-Kulak E, Orzechowska M, and Cwalina U
- Subjects
attitudes ,elderly ,geriatric pharmacology ,older adults ,over-the-counter drugs ,preferences ,self-medication ,Geriatrics ,RC952-954.6 - Abstract
Mateusz Cybulski,1 Lukasz Cybulski,2 Elzbieta Krajewska-Kulak,1 Magda Orzechowska,1 Urszula Cwalina3 1Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland; 2National Security Student, Faculty of Social Sciences, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland; 3Department of Statistics and Medical Informatics, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland Purpose: The aim of the study was to assess preferences and attitudes toward the use of over-the-counter (OTC) drugs among residents of Bialystok aged 60 or older. Patients and methods: The study included 170 people, inhabitants of Bialystok aged over 60: 85 students of the University of a Healthy Senior and the University of Psychogeriatric Prophylaxis, and 85 students of the University of the Third Age in Bialystok. The study made use of a diagnostic survey conducted via a questionnaire prepared by the authors. Results: The vast majority of respondents bought OTC drugs for own use. About one-third of the respondents from each analyzed group bought OTC drugs less often than once every 3 months. Over half of the respondents bought OTC drugs due to a cold. A majority of the respondents were of the opinion that OTC drugs should be sold only in pharmacies. Over 40% of seniors took 1 OTC drug regularly. Most respondents also took vitamins and supplements. The main sources of information on OTC drugs for the studied seniors were their doctor and pharmacist. Respondents did not always consult the treatment method with a doctor or pharmacist. Over half of the respondents familiarized themselves with the contents of the OTC drug package leaflet. Over three-quarters of the respondents were familiar with drug disposal methods; however, despite declarations of being familiar with these principles, a significant percentage did not bring back medication to a pharmacy or clinic, or threw the drugs into the trash. Conclusion: Our study found that in our sample there were many OTC drug consumers who did not always demonstrate responsible attitudes toward using this group of drugs. Thus, older people should be educated on the possible adverse effects of taking OTC drugs without consulting a doctor or pharmacist as well as basic drug disposal principles. Furthermore, legislation should be introduced that will limit the wide availability of OTC drugs, particularly to the elderly; and thus, lower the costs of hospitalization and outpatient treatment of this age group. Also, a wider-reaching study should be conducted. It should include a larger group of elderly people as well as information on intake of prescribed medications in order to be able to determine the frequency of drug consumption in this population, as well as seniors’ preferences and attitudes in this regard. Keywords: elderly, geriatric pharmacology, nutritional supplements, polypharmacy, self-medication, vitamins
- Published
- 2018
23. Studies in the Area of Antibiotics Reported from Rabin Medical Center (Effectiveness and safety of colistin among older adults: a systematic review and meta-analysis)
- Subjects
Colistin -- Health aspects -- Usage ,Geriatric pharmacology ,Health - Abstract
2022 MAY 28 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on antibiotics. According to news reporting out of [...]
- Published
- 2022
24. Arzneimittel im Alter
- Author
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Wolfgang Renteln-Kruse, Birgit Frilling, Lilli Neumann, Adelheid Kuhlmey, Wolfgang Renteln-Kruse, Birgit Frilling, Lilli Neumann, and Adelheid Kuhlmey
- Subjects
- Geriatric pharmacology, Geriatrics
- Abstract
Mit Zunahme von Multimorbidität und der Anzahl verordneter Medikamente steigt die Wahrscheinlichkeit unerwünschter Arzneimittelwirkungen im Alter. Die Versorgung älterer Menschen erfordert die Zusammenarbeit verschiedener Professionen (Pflegepersonen, Ärzte, Therapeuten u.a.). Arzneitherapiewissen ist wegen des hohen Verordnungsaufkommens für versorgende Berufsgruppen wichtig. Der Band thematisiert die wichtigsten Grundregeln der Arzneitherapie im Alter. Auf Besonderheiten des Risikofaktors Multimorbidität wird neben der Bedeutung der Arzneimittelanwendung durch ältere Patienten selbst (Adhärenz) eingegangen. Eine detaillierte Darstellung von Arzneimitteltherapien für die am häufigsten erkrankten Organsysteme sowie Geriatrischen Syndrome berücksichtigt aktuelle Forschungsergebnisse, z.B. zu potentiell inadäquater Medikation. Übersichten ermöglichen die Anwendung aktuellen Wissens in der Praxis.
- Published
- 2013
25. Arzneitherapie für Ältere
- Author
-
Martin Wehling, Heinrich Burkhardt, Martin Wehling, and Heinrich Burkhardt
- Subjects
- Geriatric pharmacology, Geriatrics
- Abstract
Sichere Arzneitherapie für ältere Patienten!Menschen im Alter über 65 Jahren bilden die am stärksten wachsende Bevölkerungsgruppe. Ältere Patienten haben häufig mehrere - oft chronische - Erkrankungen. Unerwünschte Arzneimittelwirkungen sind überdurchschnittlich häufig u.a. wegen:- geänderter biologischer Eckdaten (Leberdurchblutung und Nierenfunktion vermindert, mehr Fett- weniger Muskelmasse)- mangelnder Compliance- Vielfachmedikation mit kaum vorhersagbaren WechselwirkungenWelche Besonderheiten gibt es?Welche Nebenwirkungen/Wechselwirkungen müssen insbesondere beachtet werden - und können ggf. als neue eigenständige Erkrankungen fehlinterpretiert werden?Welche Arzneimittel sind für ältere Patienten ungeeignet bzw. erfordern besondere Vorsicht?NEUNeueste Daten, Statistiken, Key EvidencesWertungssystem für Alterstauglichkeit von Arzneimitteln nach FORTA-ListeDie Lösungsvorschläge und Antworten unter Einbeziehung neuester Daten, Statistiken und Key Evidences für die tägliche Praxis finden Sie in diesem Buch:- Medizinische Sicherheit: Welche Medikamente haben Priorität? Was darf ich weglassen?- Ökonomische Sicherheit: Bessere Arzneitherapie für den Patienten mit gleichzeitig weniger Verschreibungen (= Einhaltung des Arzneimittelbudgets).'Die schwierige Entscheidung ist häufig nicht, welche Therapie gewählt, sondern worauf verzichtet werden kann.'Prof. Georg Ertl, Vorsitzender der DGIM 2007/2008 zur Eröffnung der 114. Jahrestagung der DGIM
- Published
- 2013
26. Drug Therapy for the Elderly
- Author
-
Martin Wehling and Martin Wehling
- Subjects
- Older people, Chemotherapy, Geriatric pharmacology
- Abstract
With people aged 65 years and older currently making up the fastest growing age group throughout the world, the demographic revolution of an aging society will inevitably lead to increased pressure to develop a rationalistic and age-tailored process of diagnosis and treatment among the elderly. As aging people often suffer from several chronic diseases and are being treated with multiple medications concurrently, unwanted drug interactions occur more frequently. Whereas recent approaches have recommended to remove particular drugs from the medication regimen to avoid adverse effects, Drug Therapy for the Elderly underlines both indispensable and dispensable elements of drug treatment in order to provide an overall assessment of drugs suitable for the aged. In view of the multimorbidity and polypharmacy situations experienced by elderly patients, this book takes into account the special needs and requirements shown by this group, thus serving as a timely reference for physicians who treat the elderly.
- Published
- 2013
27. Counselling in practice: Paediatric febrile convulsions
- Author
-
Moles, Rebekah Jane
- Published
- 2016
28. Compact Clinical Guide to Geriatric Pain Management : An Evidence-Based Approach for Nurses
- Author
-
Ann Quinlan-Colwell, PhD, RNC, AHNBC, FAAPM and Ann Quinlan-Colwell, PhD, RNC, AHNBC, FAAPM
- Subjects
- Geriatric pharmacology, Older people, Pain in old age--Treatment, Chronic pain--Treatment, Pain--Measurement
- Abstract
'The care of older adults suffering with pain is a difficult task that calls for understanding as well as compassion. Dr. Quinlan-Colwell has written an excellent book that deals with every facet of the problems that are encountered by caregivers....[This book] provides the reader with valuable knowledge that will diminish suffering and enrich the lives of people confronting new, often frightening, problems.'From the Foreword by Ronald Melzack, PhD, FRSCProfessor Emeritus McGill University'This is a well-written and concise book....Nurses and other healthcare professionals will certainly find this book a useful resource for understanding and managing geriatric pain.'--Clinical Nurse SpecialistOlder adults can be especially susceptible to the debilitating effects of chronic pain, yet there are often barriers to successfully alleviating pain on the part of elderly patients and the health care professionals who treat them. This comprehensive guide to geriatric pain management provides the most current information available on assessment and treatment of pain in older adults. In a concise, reader-friendly format, the book provides techniques, tips, and tools for assessing pain and examines barriers to appropriate treatment. It addresses the physiological and psychosocial factors underlying the process and occurrence of pain and helps nurses to develop a comprehensive multimodal approach to pain management that includes pharmacological and nonpharmacological interventions. The guide provides detailed coverage of medications commonly used for pain management, including all contraindications and side effects, so that nurses will be able to evaluate the best use of a medication in the context of comorbidities and sensitivities of each individual. Also addressed are chronic illnesses common to the elderly population, palliative and hospice care, treatment of concurrent depression and anxiety, treatment of cognitively impaired elderly, and techniques for assessment and intervention in cases of substance abuse.Key Features:Provides concise yet comprehensive information on assessment and treatment of geriatric painIncludes detailed coverage of a great variety of pain medications, including contraindications and side effectsExplores barriers to appropriate treatmentCovers chronic diseases of the elderly, palliative and hospice care, depression and anxiety, substance abuse, and treatment of cognitively impaired elderlyWritten by a highly respected practitioner and educator in geriatric pain managementIncludes case studies, handy tables, questions for reflection, and references for additional study
- Published
- 2012
29. Polypharmacy, An Issue of Clinics in Geriatric Medicine
- Author
-
Holly Holmes and Holly Holmes
- Subjects
- Older people--Drug use, Geriatric pharmacology, Polypharmacy
- Abstract
With the use of multiple medications in the elderly patient comes the risk of drug-related problems. This issue covers polypharmacy in the elderly patient with topics that include: The Interplay between Polypharmacy, Geriatric Conditions, and Adverse Drug Reactions, Factors Leading to Excessive Polypharmacy, Clinical Practice Guidelines for Chronic Diseases and How They Contribute to Polypharmacy, Polypharmacy in Nursing Home Residents, Psychotropic Polypharmacy, Deprescribing Trials: Methods to Reduce Polypharmacy and the Impact on Prescribing and Clinical Outcomes, Ethical Framework for Medication Discontinuation in Nursing Home Residents with Limited Life Expectancy, Pharmacokinetics in the Elderly and the Interaction with Polypharmacy, Medication Adherence to Multi-drug Regimens, Improvements in Electronic Prescribing to Reduce Inappropriate Medication Use and Polypharmacy, and Tools to Decrease Polypharmacy.
- Published
- 2012
30. Arzneitherapie für Ältere
- Author
-
Martin Wehling, Heinrich Burkhardt, Martin Wehling, and Heinrich Burkhardt
- Subjects
- Geriatrics, Geriatric pharmacology
- Abstract
Sichere Arzneitherapie für ältere Patienten!Menschen im Alter über 65 Jahren bilden die am stärksten wachsende Bevölkerungsgruppe. Ältere Patienten haben häufig mehrere - oft chronische - Erkrankungen. Unerwünschte Arzneimittelwirkungen sind überdurchschnittlich häufig u.a. wegen:- geänderter biologischer Eckdaten (Leberdurchblutung und Nierenfunktion vermindert, mehr Fett- weniger Muskelmasse)- mangelnder Compliance- Vielfachmedikation mit kaum vorhersagbaren WechselwirkungenWelche Besonderheiten gibt es?Welche Nebenwirkungen/Wechselwirkungen müssen insbesondere beachtet werden - und können ggf. als neue eigenständige Erkrankungen fehlinterpretiert werden?Welche Arzneimittel sind für ältere Patienten ungeeignet bzw. erfordern besondere Vorsicht?NEUNeueste Daten, Statistiken, Key EvidencesDie Lösungsvorschläge und Antworten unter Einbeziehung neuester Daten, Statistiken und Key Evidences für die tägliche Praxis finden Sie in diesem Buch:- Medizinische Sicherheit: Welche Medikamente haben Priorität? Was darf ich weglassen?- Ökonomische Sicherheit: Bessere Arzneitherapie für den Patienten mit gleichzeitig weniger Verschreibungen (= Einhaltung des Arzneimittelbudgets).'Die schwierige Entscheidung ist häufig nicht, welche Therapie gewählt, sondern worauf verzichtet werden kann.'Prof. Georg Ertl, Vorsitzender der DGIM 2007/2008 zur Eröffnung der 114. Jahrestagung der DGIM
- Published
- 2011
31. Virtual Self-learning Modules Integrating Pharmacology Concepts into a Geriatric Elective
- Author
-
Laurel Gorman, Mariana Dangiolo, and Andrea Berry
- Subjects
Improved performance ,Computer science ,Short Communication ,Medicine (miscellaneous) ,Virtual function ,Pharmacology ,Geriatric pharmacology ,Education - Abstract
Given barriers to vertical integration during clinical rotations, many struggle with employing effective virtual strategies to revisit foundational sciences during clerkship. To address this, we developed virtual geriatric pharmacology self-learning modules (SLMs) for a fourth-year geriatric elective using cases, interactive exercises, resources, feedback, and quizzes. To evaluate effectiveness, learners were administered a pre- and post-elective quiz with survey. Learners improved performance after using SLMs, valued pharmacology clerkship integration and reinforcement, and agreed SLMs improved understanding, confidence, and attitudes. Thus, SLMs were an effective virtual method for integrating pharmacology that could be modified to teach other foundational sciences during clerkships.
- Published
- 2021
32. Potentiation by sevoflurane of rocuronium-induced neuromuscular block is greater in older than younger adult patients: a randomised controlled trial.
- Author
-
Takagi, Shunichi, Kitajima, Osamu, Yamamoto, Mai, Matsui, Miki, and Suzuki, Takahiro
- Subjects
- *
SUGAMMADEX , *RANDOMIZED controlled trials , *NEUROMUSCULAR blockade , *YOUNG adults , *NEUROMUSCULAR blocking agents , *INTRAVENOUS anesthesia - Published
- 2020
- Full Text
- View/download PDF
33. Arzneitherapie für Ältere
- Author
-
Martin Wehling, Heinrich Burkhardt, Martin Wehling, and Heinrich Burkhardt
- Subjects
- Geriatric pharmacology, Geriatrics, Therapeutics
- Abstract
Sichere Arzneitherapie für ältere Patienten! Menschen im Alter über 65 Jahre bilden die am stärksten wachsende Bevölkerungsgruppe. Ältere Patienten haben häufig mehrere - oft chronische – Erkrankungen. Unerwünschte Arzneimittelwirkungen sind überdurchschnittlich häufig u.a. wegen: •geänderter biologischer Eckdaten (Leberdurchblutung und Nierenfunktion vermindert, mehr Fett- weniger Muskelmasse) •mangelnder Compliance •Vielfachmedikation mit kaum vorhersagbaren Wechselwirkungen Welche Besonderheiten gibt es? Welche Nebenwirkungen/Wechselwirkungen müssen insbesondere beachtet werden – und können ggfs. als neue eigenständige Erkrankungen fehlinterpretiert werden? Welche Arzneimittel sind für ältere Patienten ungeeignet bzw. erfordern besondere Vorsicht? Die Lösungsvorschläge und Antworten für die tägliche Praxis finden Sie in diesem Buch: •Medizinische Sicherheit: Welche Medikamente haben Priorität? Was darf ich weglassen? •Ökonomische Sicherheit: Bessere Arzneitherapie für den Patienten mit gleichzeitig weniger Verschreibungen (= Einhaltung des Arzneimittelbudgets). „Die schwierige Entscheidung ist häufig nicht, welche Therapie gewählt, sondern worauf verzichtet werden kann.“ Prof. Dr. Georg Ertl, Vorsitzender der DGIM 2007/2008 zur Eröffnung der 114. Jahrestagung der DGIM
- Published
- 2010
34. The Ethics of Prescribing Medications to Older People
- Author
-
Le Couteur, David G., Kendig, Hal, Naganathan, Vasi, McLachlan, Andrew J., Koch, Susan, editor, Gloth, F. Michael, editor, and Nay, Rhonda, editor
- Published
- 2010
- Full Text
- View/download PDF
35. Dosing Errors: Age-Related Changes in Pharmacokinetics
- Author
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McLachlan, Andrew J., Hilmer, Sarah N., Le Couteur, David G., Koch, Susan, editor, Gloth, F. Michael, editor, and Nay, Rhonda, editor
- Published
- 2010
- Full Text
- View/download PDF
36. Challenges and innovations of delivering medicines to older adults.
- Author
-
Gnjidic, Danijela, Husband, Andy, and Todd, Adam
- Subjects
- *
DRUG delivery systems , *MEDICAL innovations , *COMORBIDITY , *DRUG development , *DOSAGE forms of drugs - Abstract
Abstract Older adults with multimorbidity, polypharmacy, and complex health needs are the major consumer of health care. Ensuring that medicines are used safely, effectively, and delivered efficiently in this population is challenging. In this context, the approach to medicines delivery should seek to overcome some of the difficulties of delivering medicines to older people, and ensure each medication is delivered by the optimal and most convenient route for the patient in question. However, this poses significant obstacles, as the development of medicines suitable for use in older populations does not often account for complex health needs, potential challenges in relation to drug disposition, safety of excipients and limitations with practical usability of dosage forms. The objective of this review is to summarise and discuss current challenges and novel approaches to delivering medications to older adults. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
37. ANCA-associated vasculitis (AAV) in the elderly: clinical presentation, treatment and outcomes.
- Author
-
McVay, Gillian, McGeoch, Lucy, and Chalmers, George W.
- Abstract
Purpose: To explore treatment and outcomes in older patients with AAV.Methods: Retrospective review (1 year) of patients > 75 years with positive MPO/PR3 antibodies.Results: Thirty-nine evaluable patients had new positive MPO/PR3 antibodies. Nine patients had AAV and two possible AAV (2M, 9F mean age 82 years). Nine patients had renal impairment and three died during their presenting admission, all having required dialysis ± plasma exchange. Non-survivors had higher average creatinine (442 vs 265 µmol/L) and more co-morbidities (2 or more co-morbidities vs 0 or 1). All patients deemed fit received treatment, one discontinued (infection). Survival in AAV was 46% at 1 year and 18% at 2 years. 1/3 of positive MPO/PR3 results were not acknowledged in case records by clinicians.Conclusions: Renal involvement is common in elderly patients with AAV. High creatinine, co-morbidity and need for dialysis are associated with a poorer prognosis. Mortality is high but survivors tolerate treatments well. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
38. A dual intervention in geriatric patients to prevent drug-related problems and improve discharge management.
- Author
-
Freyer, Johanna, Kasprick, Lysann, Sultzer, Ralf, Schiek, Susanne, and Bertsche, Thilo
- Subjects
GERIATRIC pharmacology ,DISCHARGE planning ,GERIATRIC rehabilitation ,MEDICATION therapy management ,INTERVENTION (Social services) ,PREVENTION of drug side effects ,CONTINUUM of care ,DRUG side effects ,HOSPITAL pharmacies ,LONGITUDINAL method ,PHARMACISTS ,REHABILITATION centers ,RESEARCH funding ,MEDICATION reconciliation - Abstract
Background Drug-related problems (DRPs) endanger geriatric patients' safety. Especially a follow-up treatment with increased number of care transitions is a critical time for patients. Objective This study aimed at optimising medication therapy and the transfer of medication-related information to ambulatory care in geriatric rehabilitation patients. Setting German geriatric rehabilitation centre (GRC). Method A prospective, controlled intervention study was performed. Patients in the control group (CG) received standard care, those in the intervention group (IG) an additional dual pharmaceutical intervention: (i) medication review to optimise in-hospital medication and (ii) improvement of discharge letters for optimising transfer of medication-related information. Main outcome measure (i) Number of patients with at least one DRP at discharge and (ii) predefined quality criteria for the discharge letters. Results 150 patients were enrolled in CG and 163 in IG. (i) At discharge, 126 (84%) patients in the CG were affected by at least one DRP. In the IG, the number of affected patients decreased to 64 (39%, P < 0.05). (ii) In comparison to discharge letters in the CG, predefined quality criteria were improved in the IG. Following differences were measured (CG vs. IG, each P < 0.05): active ingredient indicated (60 vs. 99%), brand name indicated (60 vs. 96%), explanation of medication changes (47 vs. 68%), visualisation of explanations next to the discharge medication (26 vs. 91%) and recommended therapy duration for short-term medications (49 vs. 84%). Conclusion DRPs and incomplete discharge letters affected many patients. The dual intervention improved in-hospital medication therapy and optimised the transfer of medication-related information. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
39. Nutritional Status Assessment of Elder People based on MNA Tool.
- Author
-
Khoushabia, Fahimeh, Parsi, Mohammad, Shadan, Mohammad Reza, and Bagheri, Somayeh
- Subjects
MALNUTRITION ,LIFE expectancy ,NUTRITION disorders ,GERIATRIC pharmacology ,CROSS-sectional method - Abstract
Background and Aim: Average of life expectancy through the worlds is increasingly year by year, leading to an overall increase of geriatric population. Ageing is a complex process with changes in physiological, psychological and social factors that may impact on nutritional status. As prevalence of malnutrition rises with age the aim of current research was to assess the nutritional status of elderly people Based on MNA tool. Materials and Method: A cross sectional study conducted on 303 elderly people, aged 60 years and above. The study approved by Ethics Committee of Zabol University of Medical Sciences, Iran, in 2016. A written informed consent was taken from eligible participants. The Mini Nutritional Assessment (MNA) is an instrument for identifying older people at risk of malnutrition. Anthropometric assessment (such as weight height, BMI, Mid Arm Circumference Calf Circumference) and demographic assessment are used through the MNA tool to assess the nutritional status of elderly people. Data analyzed by SPSS18 p-value of <0.05 was considered to be statistically significant Results: Mean age of participants was 70.8(8.4) year, weight was 65.0(12.1) kg, height was 164.1(9.5) cm and BMI was 24.1(4.0) kg/m
2 . Analysis of data by student t. test showed a significant difference between males and females at 5% level. The mean weight, height and BMI in male participants were higher than females (p<0.05).The nutritional status of elder people based on MNA tool showed 57.1 % of them were at risk of being malnourished, 18.5% of them were malnourished and 24.4% of them were in the normal status. A significant relationship indicated between BMI and educational levels (p<0.05), while relationship between BMI and monthly income was not significant. Data analysis showed a significant relationship observed between nutritional status with place of life and monthly income (p<5%), while relationship between nutritional status with gender was not significant. Conclusion: Prevalence of under nutrition in elderly population differs according to health status and living conditions, which by itself poses risk for higher morbidity and mortality. It is therefore especially important to evaluate their nutritional status to improve their prognosis. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
40. Evaluation of treatment satisfaction, efficacy and safety of dipeptidyl peptidase-4 inhibitors in geriatric patients with type 2 diabetes mellitus: A cross-sectionalcomparative study.
- Author
-
Singh, Harmanjit, Chakrawarti, Avinash, Singh, Harjit, Guruprasad, P, and Gupta, Yogendra
- Subjects
- *
CD26 antigen , *TYPE 2 diabetes treatment , *DRUG efficacy , *MEDICATION safety , *PATIENT satisfaction , *GERIATRIC pharmacology - Abstract
Introduction: Dipeptidyl peptidase 4 (DPP4) inhibitors are attractive agents to be used in the elderly patients with Type 2 diabetes mellitus (T2DM ) because of their beneficial effects. Methods: In this cross-sectional, observational study, we evaluated and compared the treatment satisfaction using Diabetes Treatment Satisfaction Questionnaire (DTSQ) in two groups (i.e., regimens containing DPP4 inhibitors vs. other regimens). Efficacy was evaluated by assessing and comparing the glycosylated hemoglobin (HbA1c) values and the percentage of patients who achieved the glycemic control (HbA1c <7%). The adverse drug reactions (ADRs) were also recorded and compared among two groups. Results: A total of 115 patients participated in the study (42 in Group 1 and 73 in Group 2). Significantly better DTSQ scores were observed among Group 1 patients in terms of DTSQ score total (P = 0.01) and DTSQ score for perception of hyperglycemia (P = 0.008) as compared to Group 2 patients. Significant difference was observed in HbA1c values among two groups (P = 0.02, 95% confidence interval [CI], 0.06–1.14). Also, significantly higher proportion of patients had achieved glycemic control, i.e., HbA1c <7% in Group 1 as compared to Group 2 (P = 0.002, 95% CI, 11.8%–48.1%). Significantly higher number of ADRs were observed among Group 1 patients as compared to Group 2 (P = 0.003). Conclusion: DPP4 inhibitors seem to offer better treatment satisfaction and efficacy in geriatric T2DM patients but at the expense of increased frequency of ADRs; however, further research is warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
41. Prescribing for Elderly Patients
- Author
-
Stephen Jackson, Paul Jansen, Arduino Mangoni, Stephen Jackson, Paul Jansen, and Arduino Mangoni
- Subjects
- Older people, Drugs--Dosage, Pharmacokinetics, Geriatric pharmacology, Drugs--Prescribing, Chemotherapy
- Abstract
A guide for doctors to quickly choose the right drugs in the right dose for the most important clinical problems in the elderly Prescribing medications for elderly patients is complex - this book gives clear advice on treatment regimes, drug interactions, adverse effects, and recommended dose changes Provides practical help with the problems that can arise in reaching an accurate diagnosis in the elderly, recommends clear treatment options, lists key drug interactions and side effects, and advises when to amend doses
- Published
- 2009
42. Drug-related Problems in the Elderly
- Author
-
Patrik Midlöv, Tommy Eriksson, Annika Kragh, Patrik Midlöv, Tommy Eriksson, and Annika Kragh
- Subjects
- Medication errors, Geriatric pharmacology, Drugs--Side effects
- Abstract
Drug-related problems in the elderly is intended to serve as a source of information and clinical support in geriatric pharmacotherapy for students as well as all health care professionals, e.g. physicians, nurses and pharmacists. Pharmacotherapy is of great importance to all mankind. Drugs are however powerful and must be handled appropriately. This is especially important for elderly patients. Drug-related problem is not a major subject in most university programmes in medicine or pharmacy. When there is no speci c course, there is often no book covering the topic. In our view, as teachers at various university courses, there has been a shortage of literature that re ects the most important aspects of drug-related problems in the elderly. Medical practitioners, nurses and pharmacists, need to have this knowledge to be able to serve their patients in the best way. This book covers most aspects of drug-related problems in the elderly. With b- ter knowledge of drug-related dif culties and risks we hope that elderly will have fewer drug-related problems and bene t more from their pharmacotherapy.
- Published
- 2009
43. Role of Pharmacy on Alteration of Drug Cost and Drug-Related Problem Prevention for the National Health Insurance Geriatric Outpatient.
- Author
-
Latifah, Sauriasari, Rani, and Firzawati
- Subjects
- *
GERIATRIC pharmacology , *NATIONAL health insurance , *DRUG prices , *DRUG prescribing , *PHARMACISTS - Abstract
Context: Indonesia has just taken a significant step in its efforts to roll out universal healthcare by established National Health Insurance (NHI) since 1 January 2014. Under NHI coverage, pharmacists' have an important role in preventing Drug Related Problems (DRPs) in geriatric patients through prescription review. Aims: The purpose of this study was to analyze the role of pharmacy in alteration drug costs through the prescription review to geriatric outpatient under NHI coverage and to determine the cost avoidance through a focus group discussion. Settings and Design: This study was held in general state hospital in Depok City and consist of two phase. The first phase was done with observational, retrospective, and pre-post study design. The second phase the discussion group were formed to determine cost avoidance. Methods and Material: The samples were taken from geriatric outpatient prescriptions from January to April 2016 and were designed to compare prescription costs before and after review by pharmacy staff. Statistical analysis used: Bivariate analysis was carried out to determine whether there is any difference between the cost of a prescription before and after pharmacists' prescription review. Results: The evaluation was performed on 599 prescriptions of geriatric outpatients. Prescription review resulted in cost savings of 3.78% from the total cost of pre-review prescriptions (Rp 1,773,642). The prescription cost pre- and post-review was statistically significant by the Wilcoxon test (p<0.05). The cost increased to Rp. 97,392 after being given recommendations regarding the drug-related problem through discussion groups, but these increments can result in cost avoidance by Rp. 1,466,711.4. Conclusion: Optimization of pharmacists' roles can generate significant economic benefits (cost savings and cost avoidance). [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
44. Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia.
- Author
-
Wucherer, Diana, Eichler, Tilly, Hertel, Johannes, Kilimann, Ingo, Richter, Steffen, Michalowsky, Bernhard, Thyrian, Jochen René, Teipel, Stefan, and Hoffmann, Wolfgang
- Subjects
- *
TREATMENT of dementia , *PRIMARY care , *SOCIODEMOGRAPHIC factors , *DRUG prescribing , *GERIATRIC pharmacology , *DEMENTIA , *MEDICAL prescriptions , *PRIMARY health care , *INDEPENDENT living - Abstract
Background: Potentially inappropriate medication (PIM) in older people is a risk factor for adverse drug effects. This risk is even higher in older people with dementia (PWD).Objective: Our study aimed to determine (1) the prevalence of PIM among primary care patients who were screened positive for dementia and (2) the sociodemographic and clinical variables associated with the use of PIM.Methods: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner-based, cluster-randomized, controlled intervention study to implement and evaluate an innovative concept of collaborative dementia care management in Germany. The comprehensive baseline assessment includes a home medication review. The present analyses are based on the data from 448 study participants (age 70+, DemTect <9). PIMs were identified using the list of Potentially Inappropriate Medications in the Elderly (Priscus).Results: (1) A total of 99 study participants (22%) received at least one PIM. The highest prevalence was found for antidepressants, benzodiazepines, and analgetics. The most frequently prescribed PIMs were amitriptyline, etoricoxib, and doxazosin. (2) Use of a PIM was significantly associated with a diagnosis of a mental or behavioral disorder.Conclusions: The prescription rate of PIMs for community-dwelling PWD was comparable with the rates found for the general population of older people in Germany (20-29%). Antidepressants with anticholinergic properties and long-acting benzodiazepines were the most prescribed PIMs, despite having an unfavorable benefit-risk ratio. This high prevalence of PIM prescriptions in a vulnerable population of PWD indicates that standard care for dementia should include careful medication review and management. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
45. Evaluation of polypharmacy and appropriateness of prescription in geriatric patients: A cross-sectional study at a tertiary care hospital.
- Author
-
Rakesh, K. B., Chowta, Mukta N., Shenoy, Ashok K., Shastry, Rajeshwari, and Pai, Sunil B.
- Subjects
- *
POLYPHARMACY , *GERIATRIC pharmacology , *TERTIARY care , *SOCIOECONOMIC factors , *GERIATRICS - Abstract
Objectives: To assess the polypharmacy and appropriateness of prescriptions in geriatric patients in a tertiary care hospital. Methods: An observational study was done in geriatric patients (>60 years) of either gender. The data collected from patients included: Socio-demographic data such as age, gender, marital status, educational status, socioeconomic status, occupation, nutritional status, history of alcohol/smoking, exercise history, details of comorbid diseases, medication history, findings of clinical examination etc. In this study, polypharmacy was considered as having 5 or more medications per prescription. Medication appropriateness for each patient was analysed separately based on their medical history and clinical findings by applying medication appropriateness index, screening tool to alert to right treatment (START) and Beers criteria and STOPP criteria. Results: A total of 426 patients, 216 (50.7%) were males and 210 (49.3%) were females. Polypharmacy was present in 282 prescriptions (66.2%). Highest prevalence of polypharmacy was seen in 70-79 years age group compared to the other two groups and it was statistically significant. Out of 426 patients, 36 patients were receiving drugs which were to be avoided as per Beers criteria. Among the total patients, 39 patients were overprescribed as per MAI, 56 patients were under prescribed as per START criteria and 85 out of 426 prescriptions were inappropriate in accordance with beers criteria, stop criteria, start criteria and MAI index. Conclusion: Around 66.19% patients were receiving polypharmacy. Significant number of patients were receiving drugs which are to be avoided as well as overprescribed and under prescribed. Inappropriate prescription was seen in a good number of patients. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
46. Pitfalls in Geriatric Prescribing: Antidepressants and Extreme Sedation.
- Author
-
Namiki, Hirofumi
- Subjects
- *
ANTIDEPRESSANTS , *DRUG therapy , *GERIATRIC pharmacology , *DRUG side effects , *OLDER people - Abstract
In this study, a case is presented in which initiation of an antidepressant drug was associated with an episode of extreme sedation. This case provides an opportunity to highlight possible pitfalls in geriatric prescribing. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
47. GERIATRIC PHARMACOLOGY: OVERVIEW
- Author
-
Ashok V. Shinde and Manjusha K. Borde
- Subjects
Gerontology ,business.industry ,Medicine ,business ,Geriatric pharmacology ,Geriatric Pharmacology Pharmacokinetics Pharmacodynamics - Abstract
Global population ageing is an important challenge and opportunity to be taken virtually by all the countries. Ageing is associated with progressive decline in physiological functions as well as cluster of diseases, which alter the pharmacological response to a drug. In advanced age, the pharmacokinetics and pharmacodynamics of many drugs are altered. In addition, pharmacotherapy may be complicated by difficulties with obtaining drugs or complying with drug regimens. Safe and effective pharmacotherapy remains one of the greatest challenges in geriatric medicine. This review deals with the principles of geriatric pharmacology.  
- Published
- 2020
48. The phenotype of adverse drug effects: Do emergency visits due to adverse drug reactions look different in older people? Results from the ADRED study
- Author
-
Miriam Böhme, Michael Steffens, Svitlana Igel, Katja S Just, Ingo Gräff, Julia C. Stingl, Matthias Schwab, Simon U. Jaeger, Severin Schricker, Harald Dormann, Bettina Plank-Kiegele, Thomas Seufferlein, Marlen Schurig, and Kristin Ettrich
- Subjects
Pediatrics ,medicine.medical_specialty ,adverse drug reaction ,Population ,Poison control ,emergency departments ,030226 pharmacology & pharmacy ,Drugs ,Side effects ,Drug-related side effects and adverse reactions ,03 medical and health sciences ,0302 clinical medicine ,Physicians ,Injury prevention ,Adverse Drug Reaction Reporting Systems ,Humans ,Medicine ,Pharmacology (medical) ,ddc:610 ,Arzneimittelnebenwirkung ,030212 general & internal medicine ,education ,network analysis ,older adults ,Aged ,Pharmacology ,Polypharmacy ,education.field_of_study ,business.industry ,Original Articles ,Odds ratio ,Emergency department ,medicine.disease ,Hospitalization ,Notfall ,Phenotype ,Pharmaceutical Preparations ,Older people ,Drug use ,Inappropriate prescribing ,Adverse effects ,symptoms ,Geriatric pharmacology ,Geriatrie ,Original Article ,Observational study ,Emergencies ,Emergency Service, Hospital ,business ,DDC 610 / Medicine & health ,Adverse drug reaction - Abstract
Aims Older patients in particular suffer from adverse drug reactions (ADR) when presenting in the emergency department. We aimed to characterise the phenotype of those ADRs, to be able to recognise an ADR in older patients. Methods Cases of ADRs in emergency departments collected within the multicentre prospective observational study (ADRED) were analysed (n = 2215). We analysed ADR‐associated diagnoses, symptoms and their risk profiles. We present frequencies and odds ratios (OR) with 95% confidence intervals for adults (18–64 years) compared to older adults (≥65 years; young–old 65–79, old–old ≥80 years) and regression coefficients (B) for each year of age. Results Most prominent differences were seen for drug‐associated confusion, dehydration, and bradycardia (OR 6.70 [1.59–28.27], B .054; OR 6.02 [2.41–15.03], B .081, and 4.82 [2.21–10.54], B .040), more likely seen in older adults. Bleedings were reported in all age groups, but gastrointestinal bleedings occurred with more than doubled chance in older adults (OR 2.46 [1.77–3.41], B .030), likewise did other bleedings such as haemorrhage from respiratory passages (OR 2.89 [1.37–6.11], B.036). Falls were more likely in older adults (OR 2.84 [1.77–4.53], B .030), while dizziness was frequent in both age groups. Conclusion Our data point to differences in symptoms of ADRs between adults and older individuals, with dangerous drug‐associated phenomena in the older adult such as bleedings or falls. Physicians should consider drug‐associated origins of symptoms in older adults with an increased risk for serious health problems., publishedVersion
- Published
- 2020
49. CRIDECO Anticholinergic Load Scale: An Updated Anticholinergic Burden Scale. Comparison with the ACB Scale in Spanish Individuals with Subjective Memory Complaints
- Author
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Hernán Ramos García, Gemma García-Lluch, Jordi Pérez-Tur, Lucrecia Moreno Royo, Consuelo Chafer-Pericas, Juan Pardo Albiach, Fundación Banco Santander, Universidad CEU Cardenal Herrera, Pérez-Tur, Jordi [0000-0002-9111-1712], UCH. Departamento de Farmacia, Producción Científica UCH 2022, UCH. Cátedra DeCo MICOF-CEU UCH, UCH. Departamento de Matemáticas, Física y Ciencias Tecnológicas, and Pérez-Tur, Jordi
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Alzheimer, Enfermedad de - Farmacoterapia ,Subjective memory complaint ,Medicine (miscellaneous) ,Pharmaceutical services ,Alzheimer's disease - Chemotherapy ,Anticholinergic burden scale ,Geriatric pharmacology ,Farmacología geriátrica ,Cognitive impairment ,Anticholinergic drug ,Enfermedades mentales en los ancianos - Farmacoterapia ,cognitive impairment ,anticholinergic burden scale ,anticholinergic drug ,subjective memory complaint ,Memoria - Trastornos - Farmacoterapia ,Atención farmacéutica ,Mentally ill older people - Chemotherapy ,Memory disorders - Chemotherapy - Abstract
20 páginas, 5 figuras, 5 tablas, The increase in life expectancy has also been accompanied by an increase in the use of medication to treat chronic diseases. Polypharmacy is associated with medication-related problems such as the increase in the anticholinergic burden. Older people are more susceptible to anticholinergic effects on the central nervous system and this, in turn, may be related to cognitive impairment. In this paper, we develop an updated anticholinergic burden scale, the CRIDECO Anticholinergic Load Scale (CALS) via a systematic review of the literature and compare it with the currently most used Anticholinergic Burden Scale (ACB). Our new scale includes 217 different drugs with anticholinergic properties, 129 more than the ACB. Given the effect that anticholinergic medications have on cognitive performance, we then used both scales to investigate the relationship between anticholinergic burden and cognitive impairment in adult Spanish subjects with subjective memory complaint. In our population, we observed an association between cognitive impairment and the anticholinergic burden when measured by the new CALS, but not when the ACB was applied. The use of a more comprehensive and upgraded scale will allow better discrimination of the risk associated with the use of anticholinergic medications on cognitive impairment. CALS can help raise awareness among clinicians of the problems associated with the use of medications, or combinations of them, with large anticholinergic effect, and promote a better personalized pharmacological approach for each patient., This work was supported by SANTANDER-CEU FUSP-BS-PPC26/2018
- Published
- 2022
50. Medicines optimisation in older people: Taking age and sex into account.
- Author
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Lucas, Catherine, Byles, Julie, and Martin, Jennifer H.
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GERIATRIC pharmacology , *DRUG prescribing , *PHARMACODYNAMICS , *POLYPHARMACY , *PHARMACOKINETICS , *PATIENT compliance ,SEX differences (Biology) - Abstract
There are a number of complex and seemingly ignored issues around prescribing safely and effectively for older people, particularly for very old women. These issues include polypharmacy, possible compliance issues and communication barriers between patient, specialists and general practitioners (GPs). There are specific pharmacokinetic (PK) and pharmacodynamic (PD) parameters that change in older age generally, and in women more specifically, which if ignored are likely to cause symptoms and to impair quality of life when drug dosage is unchanged. These changed PK and PD parameters are not all-or-nothing processes, but a continuum across age, sex and comorbidity. Very old people also have less 'reserve' when drugs are used in 'standard' doses, are more likely to have multiple concurrent therapies, and the risk of adverse effects of drugs in this group is very high. Doctors need to consider these issues when providing therapy for this group, or when trying to unravel the complex prescribing cascade here. This review outlines general principles to consider when prescribing for older people, focusing on age- and sex-related changes in both PK and PD processes. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
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