Drug interactions involving psychotropic drugs

2017 ◽  
Author(s):  
Subramoniam Madhusoodanan ◽  
Marina Tsoy-Podosenin ◽  
Leah R. Steinberg ◽  
Nitin Tandan
Keyword(s):  
Drug Interactions ◽  
Patient Participation ◽  
Psychotropic Drugs ◽  
The Elderly ◽  
Herbal Drugs ◽  
Over The Counter ◽  
Disease States ◽  
Age Related ◽  
Clinical Consequences ◽  
Age Related Changes

This chapter covers the various drug interactions of psychotropic agents with other drugs, over the counter (OTC) medications, food substances, herbals, alcohol, and smoking. The basic mechanisms of pharmacokinetics, pharmacodynamics, and other interactions are discussed. The disease states and age-related changes underlying the drug interactions in the elderly are briefly addressed. Drug interactions discussed have been classified as severe, moderate, or mild, according to the severity of their anticipated clinical consequences. Serious complications including death may occur in severe interactions involving cardiovascular drugs. A thorough understanding of the basis of drug interactions, and patient participation in the treatment are vital. It is also particularly important to compile a list of medications, including OTC and herbal drugs, currently taken by the patient.

Abstract T P136: Potential Contributors to the Declining Impact of Stroke Risk Factors with Age: Implications for Stroke Epidemiology in the Elderly

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
George Howard ◽  
Mary Cushman ◽  
Maciej Banach ◽  
Brett M Kissela ◽  
David C Goff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Stroke Risk Factors ◽  
Age Related ◽  
Increased Risk ◽  
The Impact ◽  
Age Related Changes

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.

scholarly journals Regenerative Medicine Approaches for Age-Related Muscle Loss and Sarcopenia: A Mini-Review

Gerontology ◽  
2017 ◽  
Vol 63 (6) ◽  
pp. 580-589 ◽  
Author(s):  
Juan Diego Naranjo ◽  
Jenna L. Dziki ◽  
Stephen F. Badylak
Keyword(s):  
Regenerative Medicine ◽  
Treatment Options ◽  
The Elderly ◽  
Signaling Molecules ◽  
Current Treatment ◽  
Muscle Physiology ◽  
Age Related ◽  
Increased Risk ◽  
And Function ◽  
Age Related Changes

Sarcopenia is a complex and multifactorial disease that includes a decrease in the number, structure and physiology of muscle fibers, and age-related muscle mass loss, and is associated with loss of strength, increased frailty, and increased risk for fractures and falls. Treatment options are suboptimal and consist of exercise and nutrition as the cornerstone of therapy. Current treatment principles involve identification and modification of risk factors to prevent the disease, but these efforts are of limited value to the elderly individuals currently affected by sarcopenia. The development of new and effective therapies for sarcopenia is challenging. Potential therapies can target one or more of the proposed multiple etiologies such as the loss of regenerative capacity of muscle, age-related changes in the expression of signaling molecules such as growth hormone, IGF-1, myostatin, and other endocrine signaling molecules, and age-related changes in muscle physiology like denervation and mitochondrial dysfunction. The present paper reviews regenerative medicine strategies that seek to restore adequate skeletal muscle structure and function including exogenous delivery of cells and pharmacological therapies to induce myogenesis or reverse the physiologic changes that result in the disease. Approaches that modify the microenvironment to provide an environment conducive to reversal and mitigation of the disease represent a potential regenerative medicine approach that is discussed herein.

scholarly journals Bone and Muscle Crosstalk in Aging

2020 ◽  
Vol 8 ◽  
Author(s):  
Chen He ◽  
Wenzhen He ◽  
Jing Hou ◽  
Kaixuan Chen ◽  
Mei Huang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bone Mineral Density ◽  
Skeletal Muscle ◽  
Bone Cells ◽  
The Elderly ◽  
Extracellular Vesicle ◽  
Mineral Density ◽  
Age Related ◽  
Age Related Changes

Osteoporosis and sarcopenia are two age-related diseases that affect the quality of life in the elderly. Initially, they were thought to be two independent diseases; however, recently, increasing basic and clinical data suggest that skeletal muscle and bone are both spatially and metabolically connected. The term “osteosarcopenia” is used to define a condition of synergy of low bone mineral density with muscle atrophy and hypofunction. Bone and muscle cells secrete several factors, such as cytokines, myokines, and osteokines, into the circulation to influence the biological and pathological activities in local and distant organs and cells. Recent studies reveal that extracellular vesicles containing microRNAs derived from senescent skeletal muscle and bone cells can also be transported and aid in regulating bone-muscle crosstalk. In this review, we summarize the age-related changes in the secretome and extracellular vesicle-microRNAs secreted by the muscle and bone, and discuss their interactions between muscle and bone cells during aging.

Inappropriate Drug Use in the Elderly: a Nationwide Register-Based Study

2007 ◽  
Vol 41 (7-8) ◽  
pp. 1243-1248 ◽  
Author(s):  
Kristina Johnell ◽  
Johan Fastbom ◽  
Måns Rosén ◽  
Andrejs Leimanis
Keyword(s):  
Drug Use ◽  
Drug Interactions ◽  
Psychotropic Drugs ◽  
The Elderly ◽  
Inappropriate Drug ◽  
Anticholinergic Drugs ◽  
Elderly Persons ◽  
Inappropriate Drug Use ◽  
Drug Register ◽  
Long Acting

Background: Potentially inappropriate drug use (IDU) is an important and preventable safety concern in the care of elderly patients and has been associated with adverse drug reactions, hospitalization, and mortality. Objective: To estimate the prevalence of potentially IDU among the elderly in Sweden and investigate whether age. sex, and number of dispensed drugs are associated with IDU. Methods: We analyzed data on age, sex, and dispensed drugs for people aged 75 years and older who were listed in the Swedish Prescribed Drug Register from October–December 2005 (N = 732 226). The main outcome measures of IDU were prescription of anticholinergics, prescription of long-acting benzodiazepines, concurrent use of 3 or more psychotropic drugs, and an indication of potentially serious drug-drug interactions. Results: Prevalence for IDU was 17%; for anticholinergic drugs 6%, long-acting benzodiazepines 5%, 3 or more psychotropic drugs 5%, and potentially serious drug–drug interactions 4%. After adjustment for age and sex, number of dispensed drugs was strongly associated with all 4 measures of IDU. After adjustment for sex and number of dispensed drugs, increasing age was moderately associated with a higher probability of IDU, long-acting benzodiazepines, and 3 or more psychotropic drugs, After adjustment for age and number of dispensed drugs, women had a slightly increased probability of IDU, anticholinergic drugs, long-acting benzodiazepines, and 3 or more psychotropic drugs. Conclusions: IDU was fairly common among the elderly in Sweden in 2005 and was strongly connected to the number of dispensed drugs they were taking. Older age and female sex were related to inappropriate use of psychotropic drugs, whereas the opposite relationship prevailed for potentially serious drug–drug interactions. Future research is needed to determine whether IDU will become more common due to increasing use of drugs among elderly persons. The challenge is to balance the problems related to IDU without denying older people potentially valuable drug therapy.

scholarly journals ORGANISING RECREATIONAL ACTIVITIES WITH THE ELDERLY IN A HEALTH RESORT INSTITUTION

2021 ◽  
Vol 35 (1) ◽  
pp. 60-66
Author(s):  
Nadezhda V. Bibikova ◽  
◽  
Liudmila N. Belonogova ◽  
Keyword(s):  
Emotional State ◽  
Healthy Lifestyle ◽  
The Elderly ◽  
Psychological Characteristics ◽  
Recreational Activity ◽  
Health Resort ◽  
Recreational Activities ◽  
Age Related ◽  
The Social ◽  
Age Related Changes

The article highlights the problem of increasing the number of the elderly people and, as a consequence, the problem of ensuring vigorous activity and maintaining a healthy lifestyle. The authors of the article determine the potential of recreational activities for solving the social and psychological problems of the elderly. The article discusses the main definitions of the concepts of «recreation», «recreational activity», the characteristics of the socio-psychological characteristics. The article presents the results of an empirical study, during which the emotional state of the elderly, their sociopsychological adaptation and readiness to accept age-related changes were diagnosed. In addition, the article describes the results of the implemented program for organizing recreational activities with the elderly.

scholarly journals Age-related changes of neutrophil characteristics, potential of activation, DNA release and NET formation

2020 ◽  
Author(s):  
Moritz Krall ◽  
Lisa-Marie Mauracher ◽  
Johanna Roiss ◽  
Lena Hell ◽  
Anna S Ondracek ◽  
...  
Keyword(s):  
Age Groups ◽  
Membrane Receptors ◽  
Lower Amount ◽  
Older Individuals ◽  
Activation Markers ◽  
Disease States ◽  
Age Related ◽  
Release Assay ◽  
Dna Release ◽  
Age Related Changes

Abstract Background: Neutrophils are a heterogeneous population of leukocytes, which can be subdivided into high and low density neutrophils (HDNs/LDNs). They are known to fight intruders with different mechanisms, including the release of neutrophil extracellular traps (NETs), which have also been associated with thrombosis. Risks of infection and thrombosis increase with age. Differences in neutrophil subpopulations and functionality have been shown in various disease states, but investigations in healthy subjects and their dependence on age are lacking. The aim of this study was to investigate age-related changes in neutrophils regarding neutrophil subpopulations, their potential of activation, DNA release and NET formation.Methods: Neutrophil subpopulations (HDNs and LDNs) were isolated from 25 healthy individuals subdivided into 3 groups (<45 years, n=8; 45-54, n=9; >54, n=8). Neutrophil characteristics, potential of activation and the ability of NET formation was investigated using flow cytometry. Externalisation of DNA was detected by a DNA release assay.Results: HDN and LDN counts did not differ between age-groups. However, with increasing age we observed a shift in neutrophil subpopulations towards a lower amount of mature LDNs, characterized by their expression of membrane receptors CD62L and CD16. Upon stimulation, neutrophils of older individuals showed significantly higher release of DNA. HDNs of younger participants increased activation markers (CD66b and CD11b) to a higher extent compared to those of older individualsConclusion: Neutrophils and their ability of activation, DNA release and NET formation change with age and this might contribute to the higher risk of infection and thrombosis at advanced age. Furthermore, these results highlight the importance and necessity of age-matching in studies that focus on neutrophil characteristics.

scholarly journals Validating the Capability for Measuring Age-Related Changes in Grip-Force Strength Using a Digital Hand-Held Dynamometer in Healthy Young and Elderly Adults

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Shu-Chun Lee ◽  
Li-Chen Wu ◽  
Shang-Lin Chiang ◽  
Liang-Hsuan Lu ◽  
Chao-Ying Chen ◽  
...  
Keyword(s):  
Young Adults ◽  
Grip Force ◽  
The Elderly ◽  
Elderly Adults ◽  
Hand Grip ◽  
Age Related ◽  
Jamar Dynamometer ◽  
Maximum Grip ◽  
Age Related Changes

Background. Grip-force performance can be affected by aging, and hand-grip weakness is associated with functional limitations of dasily living. However, using an appropriate digital hand-held dynamometer with continuous hand-grip force data collection shows age-related changes in the quality of hand-grip force control may provide more valuable information for clinical diagnoses rather than merely recording instantaneous maximal hand-grip force in frail elderly adults or people with a disability. Therefore, the purpose of this study was to indicate the construct validity of the digital MicroFET3 dynamometer with Jamar values for maximal grip-force assessments in elderly and young adults and confirmed age-related changes in the maximal and the quality of grip-force performance using the MicroFET3 dynamometer in elderly people. Methods. Sixty-five healthy young (23.3±4.5 years) and 50 elderly (69.5±5.8 years) adults were recruited and asked to perform a validity test of the grip-force maximum voluntary contraction (MVC) using both the dominant and nondominant hands with a Jamar dynamometer and a MicroFET3 dynamometer. Results. A strong correlation of maximal grip-force measurements was found between the MicroFET3 dynamometer and Jamar standard dynamometer for both hands in all participants (p<0.05). Although, the results showed that a lower grip force was measured in both hands by the MicroFET3 dynamometer than with the Jamar dynamometer by 49.9%~57% (p<0.05), but confidently conversion formulae were also developed to convert MicroFET3 dynamometer values to equivalent Jamar values for both hands. Both dynamometers indicated age-related declines in the maximum grip-force performance by 36.7%~44.3% (p<0.05). We also found that the maximal hand-grip force values generated in both hand by the elderly adults were slower and more inconsistent than those of the young adults when using the MicroFET3 dynamometer. Conclusions. This study demonstrated that the digital MicroFET3 dynamometer has good validity when used to measure the maximal grip force of both hands, and conversion formulae were also developed to convert MicroFET3 dynamometer force values to Jamar values in both hands. Comparing with the Jamar dynamometer for measuring grip force, the MicroFET3 dynamometer not only indicated age-related declines in the maximum grip-force performance but also showed slower and more inconsistent maximal hand-grip strength generation by the elderly.

scholarly journals Melatonin, aging, and COVID-19: Could melatonin be beneficial for COVID-19 treatment in the elderly?

2020 ◽  
Vol 50 (6) ◽  
pp. 1504-1512
Author(s):  
Güler ÖZTÜRK ◽  
Kazime Gonca AKBULUT ◽  
Şevin GÜNEY
Keyword(s):  
Aging Process ◽  
Biological Process ◽  
The Elderly ◽  
The Body ◽  
Biological Processes ◽  
Therapeutic Approaches ◽  
Free Radical Reactions ◽  
Age Related ◽  
The Relationship ◽  
Age Related Changes

The aim of this review is to summarize current studies on the relationship between melatonin and aging. Nowadays, age-related diseases come into prominence, and identifying age-related changes and developing proper therapeutic approaches are counted as some of the major issues regarding community health. Melatonin is the main hormone of the pineal gland. Melatonin is known to influence many biological processes in the body, including circadian rhythms, the immune system, and neuroendocrine and cardiovascular functions.Melatoninrhythms also reflect the biological process of aging. Aging is an extremely complex and multifactorial process. Melatonin levels decline considerably with aging and its decline is associated with several age-related diseases. Aging is closely associated with oxidative damage and mitochondrial dysfunction. Free radical reactions initiated by the mitochondria constitute the inherent aging process. Melatonin plays a pivotal role in preventing age-related oxidative stress. Coronavirus disease 2019 (COVID-19) fatality rates increase with chronic diseases and age, where melatonin levels decrease. For this reason, melatonin supplementation in elderly could be beneficial in COVID-19 treatment. Therefore, studies on the usage of melatonin in COVID-19 treatment are needed.

Biology of Aging

2018 ◽  
Author(s):  
Deepak Bharadia ◽  
Raquel Minasian ◽  
Indranil Sinha
Keyword(s):  
Soft Tissue ◽  
The Elderly ◽  
Free Radical Theory ◽  
Radical Theory ◽  
Care For The Elderly ◽  
Age Related ◽  
Clinical Scenarios ◽  
Specific Tissue ◽  
Biology Of Aging ◽  
Age Related Changes

With aging, there are multiple internal and external factors that are associated with age-related changes in skin and soft tissue.  As Plastic Surgeons, we very commonly evaluate and treat elderly patients, often offering ‘anti-aging’ treatments.  An understanding of the science behind aging as well as common patterns of change seen in soft tissue may allow us to refine our treatments.  This review provides an overview of mechanisms underlying aging, as well common clinical scenarios with aging regarding anatomic sites commonly treated by Plastic Surgeons including the face, breast, and abdomen.  Separately, we discuss aging associated changes to specific tissue types, including skin, fat, muscle, and bone.  Knowledge of factors related to aging and concepts related to safe interventions to reverse or mitigate age-related changes and integral to our ability to care for the elderly population.   This review contains 9 figures, 3 tables and 69 references Key Words : Cellular senescence, mitochondrial theory, free radical theory, inflammation, protein damage hypothesis, glycation hypothesis, atrophy, lipotoxicity, rhytids, involution  

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