scholarly journals Analysis of potential drug interactions and adverse reactions to nonsteroidal anti-inflammatory drugs among the elderly

2016 ◽  
Vol 19 (3) ◽  
pp. 533-544 ◽  
Author(s):  
Tiago Aparecido Maschio de Lima ◽  
Adriana Antônia da Cruz Furini ◽  
Tábata Salum Calille Atique ◽  
Patricia Di Done ◽  
Ricardo Luiz Dantas Machado ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Prescription Drugs ◽  
Adverse Reactions ◽  
Drug Distribution ◽  
The Elderly ◽  
Elderly Persons ◽  
Potential Drug ◽  
Increased Risk ◽  
Chi Squared ◽  
Elderly Users

Abstract Objective: The aim of the present study was to analyze potential drug interactions and adverse reactions to NSAIDs in elderly users of a private drug distribution service. Method: A prospective, exploratory and descriptive study with a quantitative approach was performed. The elderly users of NSAIDs attended by the service were interviewed and their prescriptions analyzed between May and September, 2014. Analysis of drug interactions was performed through computerized databases. The post-sales analysis of adverse reactions was performed using the Adverse Drug Reaction Probability Scale. Statistical analysis was performed with the Chi-squared and Fisher's Exact tests. Results: The study evaluated 200 elderly persons, among whom women predominated (56.5%). The average age was 65 years ±10. The NSAIDs accounted for 38.7% of prescription drugs used, and included dipyrone (26.9%), nimesulide (22.8%) and ketoprofen (16.3%). A total of 8.5% of such drugs were considered inappropriate medications for the elderly. A total of 104 potential drug interactions were identified, of which 24% were considered highly clinically significant. The NSAIDs with the greatest risk of interactions were ketoprofen 46.2%, ketorolac 14.4%, nimesulide 12.5% and diclofenac 9.6%. In post-sales monitoring 30.5% of the elderly persons reported undesirable symptoms after the use of NSAIDs, with stomach discomfort the most prevalent (17%). Conclusion: The present study confirmed the importance of monitoring the use of NSAIDs among the elderly due to the increased risk of drug interactions and adverse reactions associated with age, concomitant diseases, multi- prescriptions and polypharmacy. The choice of appropriate drugs for the elderly, the reconciliation of all the medications taken by the patient, and effective pharmaceutical care are measures that can contribute to the rational and safe use of NSAIDs.

scholarly journals Drug therapy, potential interactions and iatrogenesis as factors related to frailty in the elderly

2018 ◽  
Vol 21 (5) ◽  
pp. 588-596 ◽  
Author(s):  
Andressa Rodrigues Pagno ◽  
Carolina Baldissera Gross ◽  
Daiana Meggiolaro Gewehr ◽  
Christiane de Fátima Colet ◽  
Evelise Moraes Berlezi
Keyword(s):  
Drug Therapy ◽  
Drug Interactions ◽  
Inappropriate Medication ◽  
The Elderly ◽  
Potentially Inappropriate Medication ◽  
Potentially Inappropriate Medications ◽  
Elderly Persons ◽  
Potential Drug ◽  
Increased Risk ◽  
Inappropriate Medications

Abstract Objective: to investigate the use of drugs, potential drug interactions and iatrogenesis, as factors associated with frailty. Method: an observational, cross-sectional, population-based study of elderly persons registered with the Family Health Strategies of the urban area of a municipal region in the south of Brazil was carried out. The sample was probabilistic and involved 554 elderly persons; and the proportional stratified sampling technique by FHS and gender was used. Data collection was performed in the home, with the gathering of information regarding sociodemographic characteristics and pharmacotherapeutic profile and the evaluation of frailty based on Fried et al. (2001). Results: medications were taken by 86.3% of the elderly and there was a prevalence of frailty of 63.0%. A total of 39.4% of the elderly were exposed to polypharmacy, 49.1% used potentially inappropriate medications and 52.2% were exposed to potential drug interactions, the most frequent being enalapril and metformin. An association between increased risk of frailty and the variables: polypharmacy; use of potentially inappropriate medications; potential drug interactions; more than two potential drug interactions with the presence or absence of potentially inappropriate medication was identified. Conclusion: an association was found between frailty and polypharmacy, the use of potentially inappropriate medication and the presence of drug interactions. The findings underscore the importance of the monitoring of drug therapy in this population group with a view to the early detection, prevention and resolution of iatrogenesis arising from the use of medicines.

Study on medication prescription in the elderly population: benzodiazepine use and potential drug interactions

2021 ◽  
Author(s):  
Mariana Macedo Alvim ◽  
Danielle Teles da Cruz ◽  
Glenda de Almeida Aquino ◽  
Isabel Cristina Gonçalves Leite
Keyword(s):  
Drug Interactions ◽  
Elderly People ◽  
Elderly Population ◽  
Inappropriate Medication ◽  
The Elderly ◽  
Community Dwelling ◽  
Elderly Persons ◽  
Potential Drug ◽  
Elderly Individuals ◽  
Benzodiazepine Use

Abstract Background Prescription of medications for elderly individuals is complex, potentially involving polypharmacy, drug interactions, and inappropriate medication. Notable among the medications are benzodiazepines, whose long-term use is common and growing among the elderly population. Objective This study aimed to evaluate the occurrence of potential drug interactions (PDI) in elderly community-dwelling patients who use benzodiazepines. Method Cross-sectional study, conducted via household survey, with 73 elderly persons in Juiz de Fora, MG, Brazil. The search and classification of PDIs was carried out using the Micromedex® system. Results The prevalence of benzodiazepine use in this population was 18.3% (95% CI, 15.2-21.6). The use of benzodiazepines was associated with polypharmacy (p<0.01; PR 3.03; 95% CI, 1.79-5.26). A total of 157 PDI occurrences were found in 69.9% of the elderly people assessed. Of these, 25 were related to benzodiazepines. In the elderly individuals who use benzodiazepines, polypharmacy was associated with PDI (p<0.01; PR = 16.13; 95% CI, 4.67-55.55). PDI occurrence was high in the elderly people who use benzodiazepines, including interactions of highly significant clinical value. Conclusion In general, PDI is associated with polypharmacy, which demonstrates the need to rationalize drug use in the elderly population through continuous monitoring, seeking the simplest and safest possible therapeutic regimen.

scholarly journals Nutritional and hematological factors associated with the progression of Alzheimer's disease: a cohort study

2019 ◽  
Vol 65 (2) ◽  
pp. 222-231 ◽  
Author(s):  
Elizama de Gregório ◽  
Luan Henrique Patrzyk ◽  
Anne Karine Bosetto Fiebrantz ◽  
Juliana Sartori Bonini ◽  
Dayanna Hartmann Cambruzzi ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Distribution ◽  
The Elderly ◽  
Average Weight ◽  
Clinical Dementia Rating ◽  
The Public ◽  
Factors Associated ◽  
Increased Risk ◽  
Network Methods ◽  
Hematological Evaluation

SUMMARY OBJECTIVE: We studied the users of the Specialized Drug Distribution Program of the public health network. METHODS: A prospective cohort examined the elderly at two intervals of three years and included 30 patients in phase I and 16 in phase II. The methodology was composed of home visits, anthropometric, nutritional and hematological evaluation. For the progression of AD, the Clinical Dementia Rating (CDR) scale was used. RESULTS: According to the CDR, the disease evolved, since in 2014 most of the patients were in CDR 3. In the analysis of the micronutrients, only the B vitamins (B1, B2, B3, B5, B6) presented a significant reduction in 2014. The consumption of carbohydrates and lipids increased in the 2014 evaluation, and protein consumption decreased. As for the average weight of the elderly, there was an increase in 2014, 65.9 (± 15.6) Kg, with a BMI of 26.75 (± 4, 5), in 2011 the average weight was 62.44 kg (± 14, 36), BMI 24.64 (± 4.97). CONCLUSION: The hypothesis that patients are likely to be overweight or obese before the development of AD and that this may be associated with an increased risk of dementia is suggested.

Social Dimensions of Mental Illness among Rural Elderly Populations

1988 ◽  
Vol 26 (3) ◽  
pp. 169-190 ◽  
Author(s):  
Jon Hendricks ◽  
Howard B. Turner
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Physical Health ◽  
Elderly People ◽  
The Elderly ◽  
Rural Elderly ◽  
Policy Implications ◽  
Elderly Persons ◽  
Increased Risk ◽  
Elderly Populations

Despite growing concern with rural elderly populations, little attention has focused on their mental health, ways it may correlate with physical health, or how rural mental health patterns compare to urban. Popular wisdom contends that elderly people in general, and rural elderly persons in particular, are at increased risk for mental illness. This article examines these questions. A review of available literature suggests that elderly people may be at only slightly greater risk of mental illness than the population at large, though there are some indications that rates of depression may be somewhat higher among the elderly population. Much of this same literature implies that objective environmental conditions play a significant role in the incidence of depression. Analysis of data gathered in a statewide random poll ( N = 743) indicates that while physical health tends to be poorer among rural populations, when health is held constant there is actually an inverse relationship between age and depression. Therefore, rural elderly persons are no more likely to be depressed than their urban counterparts despite harsher living conditions. Both conceptual and policy implications are discussed.

Prevalence of 25-hydroxyvitamin D deficiency in subgroups of elderly persons with anemia: association with anemia of inflammation

Blood ◽  
2011 ◽  
Vol 117 (10) ◽  
pp. 2800-2806 ◽  
Author(s):  
Todd S. Perlstein ◽  
Reena Pande ◽  
Nancy Berliner ◽  
Gary J. Vanasse
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Levels ◽  
The Elderly ◽  
Vitamin D Supplementation ◽  
World Health ◽  
Elderly Persons ◽  
Increased Risk ◽  
Health Organization ◽  
Anemia Of Inflammation

AbstractAnemia and vitamin D deficiency are conditions that both result in significant morbidity and increase with age. The potential relationship between them remains poorly understood, particularly in the elderly. We used the Third National Health and Nutrition Examination Survey to examine the association of vitamin D deficiency with anemia subtypes in persons aged ≥ 60 years. Vitamin D deficiency was defined as serum levels < 20 ng/mL, and anemia was defined according to World Health Organization criteria. Vitamin D deficiency was associated with anemia prevalence independent of age, sex, or race/ethnicity (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P = .02) and varied significantly by anemia subtype (P overall = .003). The prevalence of vitamin D deficiency was 33.3% in the nonanemic population, 56% in anemia of inflammation (AI; P = .008), and 33.0% in unexplained anemia (P = .55). Non-Hispanic blacks had a 7-fold increased risk of AI compared with whites, and this was partially attenuated after adjusting for vitamin D deficiency. These data show that vitamin D deficiency is associated with specific subtypes of anemia in the elderly, especially in those with AI. Vitamin D may suppress inflammatory pathways, and studies to determine whether vitamin D supplementation ameliorates AI are warranted.

scholarly journals Prevalence and Correlates of Physical Disability and Functional Limitation among Elderly Rural Population in Nigeria

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
I. S. Abdulraheem ◽  
A. R. Oladipo ◽  
M. O. Amodu
Keyword(s):  
Physical Disability ◽  
Assessment Tool ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Sampling Technique ◽  
Female Gender ◽  
The Elderly ◽  
Elderly Persons ◽  
Cross Sectional ◽  
Increased Risk

Background. The number of people surviving into old age is increasing, and it has now become a global phenomenon. Studies on the prevalence and correlates of physical disability and functional limitation among elderly Nigerians are scanty.Methodology. This is a community-based cross-sectional study conducted in 3 local government areas (LGAs) in Nigeria, using a multistage sampling technique. Functional limitations of 1824 elderly persons were tested using Tinetti performance-oriented mobility assessment tool (TPOMAT) and self-reported activities of daily living (ADL). ADL disability of ten, six, and five basic items were compared.Results. The prevalence ratios (PRs) of physical disability using the ten, six, and five basic ADL items were 28.3 (95% CI 25.2–31. 5), 15.7 (95% CI 13.4–19.8), and 12.1 (95% CI 9.8–15.3), respectively, while functional limitation was 22.5 (95% CI 18.1–24.4). Increased risk of disability was independently associated with female gender PR 3.6 (95% CI 1.5–7.4), advanced age ≥75 years; PR 22.2 (95% CI 14.5, 36.8), arthritis PR 3.7 (95% CI 2.6–4.6), stroke PR 4.8 (95% CI 3.7–7.9) and diabetes PR 6.1 (95% CI 4.3–7.1).Conclusions. The findings from this study are pointers to unmet needs of the elderly disabled Nigerians.

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.

Drug—Drug Interactions in the Elderly

2002 ◽  
Vol 36 (11) ◽  
pp. 1675-1681 ◽  
Author(s):  
Ingeborg K Björkman ◽  
Johan Fastbom ◽  
Ingrid K Schmidt ◽  
Cecilia B Bernsten ◽  
Cecilia B Bernsten ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Elderly People ◽  
The Elderly ◽  
Drug Regimen ◽  
European Countries ◽  
Elderly Persons ◽  
Potential Ddis ◽  
Negative Effects ◽  
Outpatient Group ◽  
The Impact

OBJECTIVE: To detect the frequency of potential drug—drug interactions (DDIs) in an outpatient group of elderly people in 6 European countries, as well as to describe differences among countries. DATA SOURCES AND METHODS: Drug use data were collected from 1601 elderly persons living in 6 European countries. The study population participated in a controlled intervention study over 18 months investigating the impact of pharmaceutical care. Potential DDIs were studied using a computerized detection program. RESULTS: The elderly population used on average 7.0 drugs per person; 46% had at least 1 drug combination possibly leading to a DDI. On average, there were 0.83 potential DDIs per person. Almost 10% of the potential DDIs were classified to be avoided according to the Swedish interaction classification system, but nearly one-third of them were to be avoided only for predisposed patients. The risk of subtherapeutic effect as a result of a potential DDI was as common as the risk of adverse reactions. Furthermore, we found differences in the frequency and type of potential DDIs among the countries. CONCLUSIONS: Potential DDIs are common in elderly people using many drugs and are part of a normal drug regimen. Some combinations are likely to have negative effects; more attention must be focused on detecting and monitoring patients using such combinations. As differences in potential DDIs among countries were found, the reasons for this variability need to be explored in further studies.

A Review of Drug-Drug Interactions for Biologic Drugs Used in the Treatment of Psoriasis

2020 ◽  
pp. 120347542095242
Author(s):  
Miriam Armanious ◽  
Ronald Vender
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Potential Drug ◽  
Risk Of Infection ◽  
Biologic Therapies ◽  
Biologic Drugs ◽  
Increased Risk ◽  
Pubmed Search ◽  
Low Levels ◽  
Biologic Drug

Biologic drugs are increasingly being prescribed for the treatment of psoriasis. Very little information is available in the literature regarding potential drug interactions with these medications. This paper serves as a guide for prescribers to be aware of possible interactions between biologic drugs approved for the treatment of psoriasis in North America and concomitant therapies. Objective To provide an overview of reported drug interactions between biologic drugs and concomitant therapies. Methods Reports of potential drug interactions were compiled through a search of Micromedex, drug monographs (Canadian, American, and European), as well as a PubMed search of each biologic drug with the term “drug interaction.” Conclusion Generally, caution should be exercised when multiple immunosuppressive therapies are prescribed due to increased risk of infection. However, this is more the result of a synergistic effect as opposed to a true drug interaction. There have been cases where multiple biologic therapies have been concomitantly used without adverse events, as their mechanisms involved different pathways. The sources used to compile this guide were often comprised of low levels of evidence, reinforcing the idea that further studies are required to better direct prescribers.

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