scholarly journals A prospective observational study of prescription appropriateness of elderly hypertensive patients using Beers criteria in a tertiary care teaching hospital

2017 ◽  
Vol 6 (11) ◽  
pp. 2545 ◽  
Author(s):  
Supriya K. H. ◽  
Shashi Kumar N. S. ◽  
Prakash G. M. ◽  
Sareetha A. V.
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Angiotensin Receptor Blockers ◽  
Inappropriate Medication ◽  
Tertiary Care ◽  
Electrolyte Imbalance ◽  
Beers Criteria ◽  
Hypertensive Patients ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients

Background: The prevalence of hypertension has been increased among the urban population especially among the elderly. Use of inappropriate medication is one of the major problems seen among elderly age group above 60 years who take more medication when compared to that of younger population. Inappropriate prescriptions can be avoided by identifying safer pharmacological alternatives and also utilizing non-pharmacological therapy. Quality and safety of prescribing in elderly patients is one of the global healthcare concern and efforts should be made to improve appropriateness of medication among this group of population. This study was done to assess the relationship between inappropriate medication use and its health outcomes in elderly hypertensive population.Methods: A prospective observational study was conducted over a period of 3 months, after getting approval from Institutional Ethics Committee. Total of 117 elderly hypertensive patients aged >60 years were analysed for three months duration for the rationality of medication prescribed using Beer’s criteria and the health outcome due to inappropriate medication use.Results: Out of 117 elderly hypertensive patients analysed, 49 (41.9%) were males and 68 (58.1%) were females. Most of the patients had associated co morbid illness like diabetes mellitus (48.7%), respiratory diseases (24.8%), cerebrovascular accident (30.8%), cardiovascular diseases (19.7%), fever (13.7%), anaemia (9.4%), etc. Out of 117 patients <5 drugs were used in 6.8%, 5 -10 drugs were used in 89.7% and >10 drugs were used in 3.4% of cases. Antihypertensive drugs that were commonly used in our study was calcium channel blocker (52.1%), diuretics (42.7%), Angiotensin converting enzyme inhibitors (36.8%), β-blockers (17.1%) and Angiotensin receptor blockers (11.1%). Adverse health effects like drug induced gastritis, electrolyte imbalance, metabolic dysfunction and renal impairment was seen in few patients because of inappropriate medication.Conclusions: Use of inappropriate medication is one of the major problems seen among elderly, because of the co morbid illness associated with the primary disease which leads to polypharmacy. Prescription inappropriateness was seen among 86.3% of elderly hypertensive patients as per Beers criteria which may be because of comorbid illness that was seen among these patients. It is necessary to implement certain policies in geriatric healthcare to prevent the poor outcome due to drug therapy. 

scholarly journals The Socio-Demography, Clinical Characteristics and the Prevalence of Cardiovascular Risk Factors Among a Group of Elderly Hypertensive Patients Followed Up at A Tertiary Care Hospital in Sri Lanka.

2017 ◽  
Vol 1 (1) ◽  
pp. 3-15
Author(s):  
Udaya Ralapanawa ◽  
Sampath Tennakoon ◽  
Thilak Jayalath ◽  
Milinda Bandara ◽  
Noorika Wickramasurendra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Alcohol Consumption ◽  
Sri Lanka ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hypertensive Patients ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients

Background Hypertension is one of the most prevalent risk factors for myocardial infarction, strokes, congestive cardiac failure and chronic kidney disease (CKD)and its prevalence is significantly higher inthe elderly population. Objectives To assess the demography, various presentations and the prevalence of risk factors among elderly hypertensive patients followed up in a tertiary care hospital in Sri Lanka. Materials and Methods This was a cross sectional descriptive study involving 250 patients whoseage was 60 years or above onantihypertensives for at least 6 months. Results Approximately 65.2% of the study population was female. The mean age was 70.17.Dizziness and chest pain were the most prevalent symptoms.The mean age at first detection was 58.17 years.Mean SBP and DBP were 128.5mmHg and 81.14mmHg respectively. The prevalence of alcohol consumption and smoking among men were 70.1% and 72.4% respectively. Approximately 54.7% were either overweight or obese.Approximately 81.6% females and 41.4% males had a waist circumference ofmore than therisk level with p-value<0.05. Approximately 36% had diabetes mellitus and 27.6% of the patients had at least one parent and 36.8% had at least one sibling diagnosed with hypertension. Approximately 61.3% of the patients hadadequate levels of physical activity while 31.8% had IHD,11.5% had stroke and 3.8% had CKD. Conclusion Dizziness and chest pain were the most disturbing symptoms while abdominal obesity among females,and alcohol consumption and smoking among males were the major risk factors in elderly hypertensive patients

HYPONATREMIA IN CHILDREN OF 2 MONTHS TO 5 YEARS OF AGE WITH PNEUMONIA AND ITS CORRELATION WITH OUTCOME

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Kapil Kumar ◽  
Anita Devi ◽  
Rakes Kumar Sharma
Keyword(s):  
Observational Study ◽  
Serum Sodium ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Pneumonia ◽  
Electrolyte Imbalance ◽  
Care Hospital ◽  
Keywords Children ◽  
Who Criteria

Background: Hyponatremia is a common electrolyte imbalance observed in children with pneumonia. Presence of hyponatremia may increase the morbidity and mortality in pneumonia. The purpose of the study was to find the frequency of hyponatremia in 2 months to 5 years old children hospitalized with pneumonia and to correlate the hyponatremia with the severity of pneumonia. Methods: This prospective observational study involved 100 children of 2 months to 5 years, admitted in tertiary care hospital with pneumonia. Subjects were classified as pneumonia and severe pneumonia according to WHO criteria. Relevant demographic, clinical data and outcome of the patients were noted. Serum sodium was analyzed and was correlated with severity of pneumonia. Results: Out of 100 children included in this study, 64 were boys and 36 were girls. Hyponatremia was found in 43.0% of children with pneumonia. Mild hyponatremia was the commonest and seen in 26 children. Mortality was more in children with hyponatremia compared to normonatremia. Conclusion: Hyponatremia is a common electrolyte imbalance found in pneumonia and more commonly seen in severe pneumonia. Hyponatremia is associated with increased mortality.  Keywords: Children, Hyponatremia, Mortality, Pneumonia.

The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

2020 ◽  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Normal Saline ◽  
Saline Group ◽  
Normal Saline Group ◽  
Hypertensive Patients ◽  
Group A ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients ◽  
Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

Nocturnal Fall of Blood Pressure and Silent Cerebrovascular Damage in Elderly Hypertensive Patients

Hypertension ◽  
1996 ◽  
Vol 27 (1) ◽  
pp. 130-135 ◽  
Author(s):  
Kazuomi Kario ◽  
Takefumi Matsuo ◽  
Hiroko Kobayashi ◽  
Masahiro Imiya ◽  
Miyako Matsuo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Hypertensive Patients ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients
Sign in / Sign up

Export Citation Format

Share Document