scholarly journals POLYPHARMACY IN ELDERLY PATIENTS AND THEIR PROBLEMS

2017 ◽  
Vol 10 (7) ◽  
pp. 44 ◽  
Author(s):  
Siti Fauziyah ◽  
Maksum Radji ◽  
Retnosari Andrajati
Keyword(s):  
Health Status ◽  
Elderly Patients ◽  
Physical Examination ◽  
Fall Prevention ◽  
Geriatric Patients ◽  
The Elderly ◽  
Prescribing Patterns ◽  
Drug Reactions ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Important Approach

 Aging and diseases associated with aging is a condition associated with old age. An important approach to maintaining health status and physical examination in geriatric patients is very important, including nutrition problems, sight, hearing, urine containment, balance and fall prevention, osteoporosis, and polypharmacy. The use of polypharmacy will give some impact on the elderly, including increasing the improper treatment, adverse drug reactions (ADRs), and some of the problems that affect the changing nature of the pharmacokinetics and pharmacodynamics of drugs. Aging in the elderly with some diseases, the possibility of getting more number of drugs consequently has the potential to improve prescribing patterns that are not appropriate and contribute to ADRs and hospitalizations. This review will describe the effect of polypharmacy in elderly patients.

scholarly journals Thyroid cancer surgery in the elderly: a comparative study of 1176 patients

2018 ◽  
Vol 5 (6) ◽  
pp. 2000
Author(s):  
Omer Parlak ◽  
Fatma Dilek Dellal ◽  
Serap Ulusoy ◽  
Ibrahim Kılınc
Keyword(s):  
Thyroid Cancer ◽  
Elderly Patients ◽  
Geriatric Patients ◽  
The Elderly ◽  
Cancer Surgery ◽  
Cancer Type ◽  
Capsular Invasion ◽  
Significant Difference ◽  
Surgery In The Elderly ◽  
Male Patients

Background: The aim of this study is to compare the results of patients who were treated with two groups (under 65 years and over 65 years) of thyroid cancer.Methods: A retrospective review of 1176 patients undergoing thyroid cancer surgery between January 2007 and December 2016 was performed. Patients were grouped as ≥65 (geriatric group) and <65 years (non-geriatric group).Results: A total of 139 patients (11.8%) were over 65 years of age and 1037 patients (88.2%) were under 65 years of age. There were 104 female (74.8%) and 35 (25.2%) male patients in the geriatric group. In the non-geriatric group, 917 (78%) patients were female and 259 (22%) were male (p = 0.39). FNAB showed a significant increase in malignant potential in the elderly (p = 0.005). In our series, malignant differences between geriatric and non-geriatric groups are less pronounced among thyroid carcinomas other than capsular invasion. Although there was no significant difference in histopathologic examination, malignant cytology was higher in the elderly patients. There was no significant difference between the young and elderly patients in terms of complication.Conclusions: In this study, papillary Thyroid Ca (PTC) was found to be the most common type of cancer and we could not find any difference in cancer type distribution in geriatric and non-geriatric patients. Total/near total thyroidectomy in experienced hands is safe for elderly patients. There is no difference in terms of complication.

Optimising health economic evaluations for geriatric cancer patients

2017 ◽  
Vol 23 (03) ◽  
pp. 123-128
Author(s):  
Andrea Goettler ◽  
Tanja-Maria Kessel ◽  
Diana Sonntag
Keyword(s):  
Health Economic ◽  
Elderly Patients ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Geriatric Patients ◽  
The Elderly ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Cost Calculation ◽  
Geriatric Cancer

Abstract Aim Despite the growing number of elderly cancer patients, health economic evaluations have not put enough attention on this patient group. We reflect on the current state of health economic evaluations for geriatric patients and present suggestions for improvements. Method We reviewed the scientific literature on health economic evaluations for geriatric patients in Germany and internationally. Additionally, we conducted a scoping review on cost-utility analyses on cancer treatment for older patients (> 60 years). Results The literature review resulted in eight relevant studies. Besides the paucity of economic evaluations for elderly patients, we also present quality limitations. From the literature, we identify four recommendations regarding cost calculation, geriatric assessment, patient decision-making and quality of life on how to design better economic evaluations for geriatric cancer treatment. Conclusion The demographic change requires more attention regarding elderly patients in health economics. Including patients above 70 years of age in health economic evaluations and improving cost-utility analyses will help to improve resource allocations and effective healthcare for the elderly.

Co-prescribing Patterns of Contraindicated Drugs for the Elderly Patients in Busan.

2008 ◽  
Vol 30 (1) ◽  
pp. 128-136
Author(s):  
Nam Kyong Choi ◽  
Sun Young Jung ◽  
Byung Joo Park
Keyword(s):  
Elderly Patients ◽  
The Elderly ◽  
Prescribing Patterns

Iatrogenic (drug induced) cognitive disorders

2020 ◽  
Vol 26 (4) ◽  
pp. 248-254
Author(s):  
Igor’ V. Damulin ◽  
Alla A. Strutsenko
Keyword(s):  
Adverse Effect ◽  
Drug Therapy ◽  
Elderly Patients ◽  
Neurological Disorders ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Drug Induced ◽  
Younger Age ◽  
Increased Sensitivity

This article discusses the clinical and pathogenetic aspects of iatrogenic (drug induced) cognitive disorders. It is emphasized that in most cases the etiology of these disorders is multifactorial in nature. In some cases, iatrogenic disorders are caused by the intake of an inadequately large dose of the drug, while in other cases, they are caused by the side effect of drugs. Disorders such as cerebral homeostasis, impaired permeability of the bloodbrain barrier and the neurochemical properties of a certain drug are important. Side effects of drug therapy in elderly patients are much more common than in patients of a younger age, which is due to a number of causes, namely the poly-pragmasy characteristic of the elderly patients, erroneous prescription of certain drugs, drug interactions, altered pharmacokinetics and pharmacodynamics, and increased sensitivity to medications. Various groups of drugs are considered, during the intake of which, neuropsychiatric disorders may occur. In this case, special attention is paid to drugs with cholinolytic properties. Neurological disorders arising from radiation therapy were analyzed separately. It was concluded that it is necessary to assess the possible adverse effect of previously prescribed drug therapy for various indications in patients with cognitive impairment.

Changes in Pharmacokinetics and Pharmacodynamics in the Elderly Patient

2007 ◽  
Vol 20 (1) ◽  
pp. 4-12 ◽  
Author(s):  
Lisa C. Hutchison ◽  
Catherine E. O'Brien
Keyword(s):  
Elderly Patient ◽  
Elderly Patients ◽  
The Elderly ◽  
Pharmacokinetic Parameters ◽  
Beers Criteria ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Drug Dosing ◽  
Central Nervous System Agents ◽  
The Common ◽  
Pharmacologic Agents

The use of pharmacologic agents in elderly patients is one of the most difficult aspects of patient care. An understanding of the common physiologic changes expected with aging is helpful to anticipate changes expected in pharmacokinetic parameters. Distribution, metabolism, and excretion are significantly altered for many drugs. In addition, pharmacodynamic variations in elderly patients may increase or decrease sensitivity to a medication independent of pharmacokinetic changes. These alterations are particularly noteworthy with cardiovascular and central nervous system agents. Current controversies regarding the application of estimation of renal function to drug dosing and use of the Beers criteria of medications potentially inappropriate in the elderly are discussed.

scholarly journals Predicting Outcomes of Abdominal Surgical Emergencies in the Elderly Population Using a CT Muscle Gauge

2020 ◽  
Author(s):  
Yu-San Tee ◽  
Chi-Tung Cheng ◽  
Yu-Tung Wu ◽  
Chih-Po Hsu ◽  
Shih-Ching Kang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Elderly Population ◽  
Geriatric Patients ◽  
Psoas Muscle ◽  
The Elderly ◽  
Ease Of Use ◽  
Specific Reference ◽  
Cutoff Values ◽  
European Working ◽  
Abdominal Emergencies

Abstract Background: Frailty has been shown to be an independent negative predictor of surgical outcomes in geriatric patients. Traditional measurements of frailty are impractical in emergency settings, and computed tomography (CT)-measured skeletal muscle mass has been proposed as an alternative. However, the cutoff values of these CT metrics for frailty are still unknown, and their impact on abdominal emergencies in the elderly population is unclear.Study Design: A total of 462 young trauma patients aged 18-40 years were analyzed to establish sex-specific reference cutoff values for the CT-measured muscle index (MI) and muscle gauge (MG) values. The impacts of low MI and MG values were investigated in 1192 elderly patients (aged ≥ 65 years) undergoing abdominal surgery.Results: The sex-specific cutoff values for MI and MG were determined by adopting European Working Group on Sarcopenia in Older People (EWGSOP) guidelines. The correlation between MG and ageing was significantly stronger than that between MI and ageing. With regard to the MG, the L4 psoas muscle gauge (L4 PMG) was further investigated in an elderly cohort owing to its high predictive value and ease of use in the clinical setting. A low L4 PMG value was an independent risk factor for overall complications and mortality in elderly patients with abdominal emergencies.Conclusion: The current study was the largest study investigating the correlations between MG values and ageing in the Asian population. Frailty, as indicated by a low L4 PMG value, may help surgeons during preoperative decision making regarding geriatric patients with abdominal emergencies.

scholarly journals Az időskori gyógyszerterápia alapjai

2019 ◽  
Vol 160 (23) ◽  
pp. 896-907
Author(s):  
András Telekes ◽  
Dániel Deme
Keyword(s):  
Elderly Patients ◽  
Daily Practice ◽  
The Elderly ◽  
Developed Countries ◽  
Elderly Subjects ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Important Place ◽  
Pharmaceutical Therapy ◽  
The Social ◽  
The Developed Countries

Abstract: The proportion of elderly patients is getting increased in the developed countries as a consequence of which pharmacotherapy takes a more and more important place in the healthcare system. Important biological alterations are characteristic for the elderly subjects, which have effect on the pharmacokinetics and pharmacodynamics of the pharmaceuticals. Gradually decreased kidney function may demand the modification of the administration of the pharmaceuticals. Certain pharmaceuticals and drug-interactions are potentially dangerous for this population. Therefore several factors have to be taken into account in conjunction with the therapy of elderly patients including co-morbidities, cognitive function and the social state. At the same time, the risk–benefit ratio of the pharmaceuticals is the worst among elderly patients with pharmaceutical therapy including polypragmasy. Thus, it is inevitable for the development of geriatric pharmacotherapy that the physiologic alteration of elderly has to be taken into account not only in the daily practice but also during the development and formulation of a pharmaceutical. The present paper gives an overview of the most important factors influencing the pharmacotherapy of the elderly. Orv Hetil. 2019; 160(23): 896–907.

scholarly journals EFFECTIVENESS OF EDUCATIONAL INTERVENTIONS FOR FALL PREVENTION: A SYSTEMATIC REVIEW

2021 ◽  
Vol 30 ◽  
Author(s):  
Maria Aline Moreira Ximenes ◽  
Maria Girlane Sousa Albuquerque Brandão ◽  
Thiago Moura de Araújo ◽  
Nelson Miguel Galindo Neto ◽  
Lívia Moreira Barros ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nursing Homes ◽  
Elderly Patients ◽  
Fall Prevention ◽  
Experimental Studies ◽  
The Elderly ◽  
Educational Interventions ◽  
Exposure Factor ◽  
Fall Rates

ABSTRACT Objective: to assess the effectiveness of educational interventions for fall prevention implemented in hospitals, at homes and nursing homes. Method: this is a systematic review, carried out based on the guiding question: what is the effectiveness of isolated educational interventions for preventing falls in adults and the elderly developed in experimental studies? The search took place in the electronic databases: Scopus, PubMed/PMC, Web of Science, CINAHL, SciELO, Cochrane and EMBASE. The exposure factor was the educational intervention on preventing falls, and as outcomes: reducing fall rates, improving knowledge, awareness and adherence to preventive care for adult and elderly patients. Only randomized controlled trials, in all languages and published between 2011 and 2020 were included. Results: 1,474 articles were identified, of which 16 were included. Four studies did not show effectiveness related to fall prevention. As common characteristics, these studies were carried out with elderly patients and without one-to-one follow-up. The others were effective in reducing falls and/or improving knowledge and were mostly studies with personalized interventions, carried out by nurses and mediated by educational technologies. Conclusion: educational interventions are effective for preventing falls in the home, hospital and nursing homes. Studies have shown a reduction in fall rates, improved knowledge and engagement in prevention strategies.

scholarly journals PROCESSO DE ENFERMAGEM APLICADO À IDOSOS COM ALZHEIMER QUE PARTICIPAM DO PROJETO ESTRATÉGIAS DE REABILITAÇÃO

2011 ◽  
Vol 16 (esp) ◽  
Author(s):  
Carine Magalhães Zanchi de Mattos ◽  
Solange Beatriz Billig Garces ◽  
Fátima Terezinha Lopes da Costa ◽  
Carolina Boettge da Rosa ◽  
Angela Vieira Brunelli ◽  
...  
Keyword(s):  
Health Status ◽  
Physical Examination ◽  
Nursing Care ◽  
Memory Impairment ◽  
The Elderly ◽  
Nursing Process ◽  
Care Assistance ◽  
Nursing Diagnoses ◽  
Stimulation Of

Introdução: O aumento da população idosa em todo o mundo exige a capacitação de profissionais para o atendimento nesta área. Metodologia: Este é um estudo qualiquantitativo do tipo exploratório-descritivo realizado através da entrevista e exame físico feito nos idosos. Objetivos: O objetivo geral deste trabalho foi aplicar  o processo de enfermagem nos idosos com alzheimer participantes do projeto da UNICRUZ. Os objetivos específicos foram:  Realizar a avaliação do estado de saúde atual destes idosos; Levantar os principais diagnósticos de enfermagem encontrados; Proporcionar aos sujeitos cuidados de enfermagem integral através da realiazação das prescrições de enfermagem. Resultados: Após a coleta de dados foram levantadas as informações em comum obtidas na entrevista e exame físico que apontam idade média dos sujeitos de 76 anos, 4 idosos têm o diagnóstico de alzheimer há 5 anos; 3 deles são hipertensos; 5 deles têm distúrbios do sono; 3 têm irmãos com alzheimer e todos têm falha de memória e limitação de amplitude de movivento. Dos diagnósticos de enfermagem, pode-se destacar -  tensão do papel do cuidador e risco para o trauma. Dentre as  principais prescrições de enfermagem estão - estimular cognição e memória, atividade física e participação social. Conclusão: Foi possível aplicar o processo de enfermagem nos idosos e com isso obter um maior conhecimento do estado de saúde deles,  descrever os diagnósticos de enfermagem e levantar pontos de intervenção através da prescrição de enfermagem para promover cuidados como o estímulo à participação em grupos e encaminhamento ao odontólogo que poderão auxiliar no tratamento dos indivíduos e previnir complicações, oferecendo-os assistência e orientações de enfermagem e transdiciplinar. palavras chave Processo de enfermagem. Cuidado de enfermagem. Assistência à idosos. Doença de Alzheimer.abstract Introduction: The aging population in the world requires the training of professionals providing care in this area. Methodology: This qualitative-quantitative study is of the exploratory-descriptive type conducted by interview and physical examination in the elderly. Objectives: The aim of this work was to apply the nursing process in the elderly with Alzheimer's UNICRUZ project participants. The specific objectives were to perform the evaluation of current health status of elderly; Raise the main nursing diagnoses found; subject providing comprehensive nursing care through nursing realization prescriptions. Results: After data collection, it was raised together the information obtained in the interview and physical examination suggest that the average age of subjects 76 years, has four seniors diagnosed with Alzheimer's five years, three of them are hypertensive, five of them have disorders sleep, have three siblings with Alzheimer's and all have memory impairment and limitation of range of movivento. Of nursing diagnoses, can be highlighted - the role of caregiver stress and risk for trauma. The main requirements are nursing - stimulate cognition and memory, physical activity and social participation. Conclusion: It was possible to apply the nursing process in the elderly and therefore gain a greater understanding of their health status, describing nursing diagnoses and raise points of intervention through the prescription of nursing care and to promote the stimulation of participation in groups and referral to a dentist that can help treat and prevent complications of individuals, offering them assistance and guidance to nursing and transdisciplinary. Key wordsNursing Process. Nursing care. Assistance to the elderly. Alzheimer's disease.

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