2019 ◽  
Vol 34 (12) ◽  
pp. 2720-2722 ◽  
Author(s):  
Nancy L. Schoenborn ◽  
Jin Huang ◽  
Cynthia M. Boyd ◽  
Sarah Nowak ◽  
Craig E. Pollack

2020 ◽  
pp. 571-578
Author(s):  
Miles Witham ◽  
Jacob George ◽  
Denis O’Mahony

The use of pharmacological agents is often a central component of medical therapy for older people. Medications can relieve symptoms, improve function, and prevent illness, but they also have the capacity to inflict great harm. Older people are at particular risk of such harms as a result of impaired homeostatic reserve, of altered drug metabolism, the presence of multimorbidity and consequent polypharmacy, which increases both exposure to potentially harmful agents and the chance of drug–drug interactions. The therapeutic priorities for older, frail people may differ when compared to younger, robust patients; limited life expectancy means that attempts to prolong life may become relatively less important than the relief of symptoms and avoidance of side effects and medication burden.


2019 ◽  
Vol 28 (6) ◽  
pp. 501-508 ◽  
Author(s):  
Luca Pasina ◽  
Barbara Brignolo Ottolini ◽  
Laura Cortesi ◽  
Mauro Tettamanti ◽  
Carlotta Franchi ◽  
...  

Objective: Older people approaching the end of life are at a high risk for adverse drug reactions. Approaching the end of life should change the therapeutic aims, triggering a reduction in the number of drugs.The main aim of this study is to describe the preventive and symptomatic drug treatments prescribed to patients discharged with a limited life expectancy from internal medicine and geriatric wards. The secondary aim was to describe the potentially severe drug-drug interactions (DDI). Materials and Methods: We analyzed Registry of Polytherapies Societa Italiana di Medicina Interna (REPOSI), a network of internal medicine and geriatric wards, to describe the drug therapy of patients discharged with a limited life expectancy. Results: The study sample comprised 55 patients discharged with a limited life expectancy. Patients with at least 1 preventive medication that could be considered for deprescription at the end of life were significantly fewer from admission to discharge (n = 30; 54.5% vs. n = 21; 38.2%; p = 0.02). Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, lipid-lowering drugs, and clonidine were the most frequent potentially avoidable medications prescribed at discharge, followed by xanthine oxidase inhibitors and drugs to prevent fractures. Thirty-seven (67.3%) patients were also exposed to at least 1 potentially severe DDI at discharge. Conclusion: Hospital discharge is associated with a small reduction in the use of commonly prescribed preventive medications in patients discharged with a limited life expectancy. Cardiovascular drugs are the most frequent potentially avoidable preventive medications. A consensus framework or shared criteria for potentially inappropriate medication in elderly patients with limited life expectancy could be useful to further improve drug prescription.


2019 ◽  
Vol 85 (5) ◽  
pp. 868-892 ◽  
Author(s):  
Carina Lundby ◽  
Trine Graabæk ◽  
Jesper Ryg ◽  
Jens Søndergaard ◽  
Anton Pottegård ◽  
...  

2016 ◽  
Vol 45 (suppl 2) ◽  
pp. ii1.10-ii12 ◽  
Author(s):  
Amanda Lavan ◽  
Paul Gallagher ◽  
Carole Parsons ◽  
Denis O'Mahony

1997 ◽  
Vol 111 (7) ◽  
pp. 654-655 ◽  
Author(s):  
P. Bhandarkar ◽  
K. M. J. Green ◽  
J. P. de Carpentier

AbstractA case of laryngeal squamous cell carcinoma recurrence presenting as multiple cutaneous metastases is presented. Such metastases are rare and are associated with a poor prognosis. Treatment is usually aimed at providing pain relief in these patients with a limited life expectancy.


2016 ◽  
Vol 46 (4) ◽  
pp. 493-496 ◽  
Author(s):  
P. S. Nishtala ◽  
D. Gnjidic ◽  
T. Chyou ◽  
S. N. Hilmer

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