Senior Care Pharmacist最新文献_第2页

MDMA Therapy for PTSD: Inching Closer to-or Farther From-Approval? 治疗创伤后应激障碍的摇头丸疗法：离批准越来越近还是越来越远？

Senior Care Pharmacist Pub Date : 2024-08-01 DOI: 10.4140/TCP.n.2024.311

Leigh Davitian

引用次数: 0

The 2023 American Geriatrics Society Updated Beers Criteria^® Application in Low- and Middle-Income Countries: A Walk-through. 2023 年美国老年医学会更新的 Beers Criteria® 在中低收入国家的应用：走马观花。

Senior Care Pharmacist Pub Date : 2024-08-01 DOI: 10.4140/TCP.n.2024.286

Jehath Syed, Sri Harsha Chalasani

引用次数: 0

Review of Current Clinical Options for the Management of Behavioral and Psychological Symptoms of Dementia. 当前治疗痴呆症行为和心理症状的临床方案回顾。

Senior Care Pharmacist Pub Date : 2024-08-01 DOI: 10.4140/TCP.n.2024.300

Katelyn Malena, Shantanu Rao, Charles Mosler

{"title":"Review of Current Clinical Options for the Management of Behavioral and Psychological Symptoms of Dementia.","authors":"Katelyn Malena, Shantanu Rao, Charles Mosler","doi":"10.4140/TCP.n.2024.300","DOIUrl":"10.4140/TCP.n.2024.300","url":null,"abstract":"Dementia is a disease most prevalent in the older adult population. The cognitive symptoms of dementia include impairments in problem-solving, memory, and language. Some patients experience noncognitive symptoms in addition to the cognitive symptoms of dementia. These noncognitive symptoms are called behavioral and psychological symptoms of dementia or BPSD. The primary objective of our study was to examine the therapeutic options, guidelines, and clinical considerations for the management of BPSD. The existing literature about BPSD was reviewed with searches in PubMed, MEDLINE, and online search platforms. Dysregulation of neurotransmission involving acetylcholine, dopamine, and serotonin has been shown to cause behavioral and psychological symptoms of Alzheimer's disease. BPSD can include hallucinations, agitation, delusions, anxiety, apathy, abnormal body movements, irritability, depression, disinhibition, and sleep or appetite changes. Pharmacologic therapies used in the treatment of BPSD include antidepressants, antipsychotics, anxiolytics, and anticonvulsants. Treatment can be tailored to the specific noncognitive symptoms that are experienced. The use of these agents may be limited based on recommendations from the Beers Criteria®, STOPP criteria, treatment guidelines, and FDA warnings.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Centers for Medicare & Medicaid Services Tackle Nurse Staffing Rule: Fairy Tale Ending or Endless Litigation? 医疗保险与医疗补助服务中心处理护士配置规则：童话般的结局还是无休止的诉讼？

Senior Care Pharmacist Pub Date : 2024-07-01 DOI: 10.4140/TCP.n.2024.277

Leigh Davitian

引用次数: 0

Unintended Consequences: Consider the Rabbit. 意外后果：考虑兔子

Senior Care Pharmacist Pub Date : 2024-07-01 DOI: 10.4140/TCP.n.2024.238

Chris Alderman

引用次数: 0

Utilization of Lower-Dose Cyclobenzaprine in the Older Inpatient. 低剂量环苯扎林在老年住院患者中的应用。

Senior Care Pharmacist Pub Date : 2024-07-01 DOI: 10.4140/TCP.n.2024.249

Katherine G Coli, Jaylan M Yuksel, Kenneth L McCall, Jiajie Guan, Kelly R Ulen, John Noviasky

{"title":"Utilization of Lower-Dose Cyclobenzaprine in the Older Inpatient.","authors":"Katherine G Coli, Jaylan M Yuksel, Kenneth L McCall, Jiajie Guan, Kelly R Ulen, John Noviasky","doi":"10.4140/TCP.n.2024.249","DOIUrl":"10.4140/TCP.n.2024.249","url":null,"abstract":"Background In older inpatients, anticholinergic medications can increase the risk of complications that may increase length of stay (LOS). Cyclobenzaprine is an anticholinergic medication associated with mental status changes, falls, and injuries in older patients. Objective The purpose of this study is to determine whether use of a lower cyclobenzaprine dose (5 mg) compared with higher dosing (10 mg) will affect LOS, 30-day readmission rates, and need for injectable psychotropic agents in inpatients 65 years of age and older. Methods This was a retrospective cohort analysis comparing outcomes in patients 65 years of age and older who received either a 5 mg or 10 mg cyclobenzaprine dose during their inpatient admission over a 2.5-year period. The primary outcome was hospital LOS, adjusted using multivariate linear regression. Secondary outcomes included 30-day readmission rate adjusted using logistic regression and use of injectable antipsychotics or benzodiazepines. A sub-analysis evaluated the impact of the institution's implementation of a geriatric prescribing context (GEM-CON) on cyclobenzaprine dose selection. Results The adjusted LOS was 32.7% longer (95% CI 25.9%-39.9%) for patients exposed to higher-dose cyclobenzaprine. Use of injectable antipsychotics or benzodiazepines was also significantly greater in the higher-dose group (P < 0.001; P = 0.025). Cyclobenzaprine dose was not significantly associated with readmission on multivariate analysis (OR = 0.93, 95% CI 0.45-1.93). After GEM-CON implementation, there was a significant increase in use of the recommended lower cyclobenzaprine dose (P < 0.001). Conclusion Use of lower cyclobenzaprine dosing in older inpatients is associated with reduced hospital LOS and need for injectable antipsychotics and benzodiazepines.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What Is Pharmacoepidemiology and How Does It Inform Clinical Care? 什么是药物流行病学，它如何为临床护理提供信息？

Senior Care Pharmacist Pub Date : 2024-07-01 DOI: 10.4140/TCP.n.2024.240

Jodie Hillen

引用次数: 0

Improved Outcomes When Home-Dose Carbidopa-Levodopa Is Continued in the Geriatric Emergency Department in Patients With Parkinson's Disease. 帕金森病患者在老年急诊科继续服用家庭剂量卡比多巴-左旋多巴可改善疗效。

Senior Care Pharmacist Pub Date : 2024-07-01 DOI: 10.4140/TCP.n.2024.242

Jaylan M Yuksel, Kelly R Ulen, Jay M Brenner, Sharon A Brangman, John Noviasky

{"title":"Improved Outcomes When Home-Dose Carbidopa-Levodopa Is Continued in the Geriatric Emergency Department in Patients With Parkinson's Disease.","authors":"Jaylan M Yuksel, Kelly R Ulen, Jay M Brenner, Sharon A Brangman, John Noviasky","doi":"10.4140/TCP.n.2024.242","DOIUrl":"10.4140/TCP.n.2024.242","url":null,"abstract":"Parkinson's disease (PD) is a debilitating condition that affects 1.8% of people 65 years of age and older. Patients with PD often require hospitalization and are frequently admitted through the emergency department (ED). Notably, their hospital durations tend to be lengthier compared with patients without PD. The primary outcome of this research was to compare the length of stay (LOS) of patients who received carbidopa-levodopa (CL) in the ED with those who did not. Secondary outcomes included 30-day-readmission rates and administration of injectable for agitation. In addition, the percentage of patients receiving CL before and after an information management technology (IMT) alert implementation was compared in a sub-analysis. Patients that received CL during their inpatient stay were identified by a database report in this retrospective study. Patients were excluded if they were not admitted through the ED, younger than 65 years of age, or admitted to the intensive care unit after the ED. There was a total of 266 in the control group and 217 patients in the intervention group. The intervention group had a significantly shorter LOS than the control group (3.29 vs 5.37 days; P = 0.002), significantly less frequent 30-day readmissions (P = 0.032), and used fewer injectables for agitation (P = 0.035). The sub-analysis of the IMT alert revealed that prior to the alert's implementation, 28.5% of patients received CL in the ED; whereas post-alert, this percentage increased to 91.4% (P < 0.001). The results of this study found that the group of PD patients who received CL in the ED had shorter LOS, lower 30-day readmissions, and used less injectables for agitation compared with the group that did not receive CL in the ED. This improvement is possibly due to continuity of CL supply considering its short half-life and clinical importance for PD.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sulfamethoxazole-Trimethoprim-Induced Hyperkalemia in Hospitalized Patients Using Potassium-Sparing Drugs: An Observational Study. 使用保钾药物的住院病人中磺胺甲噁唑-三甲氧苄啶诱发的高钾血症：一项观察性研究。

Senior Care Pharmacist Pub Date : 2024-07-01 DOI: 10.4140/TCP.n.2024.259

Madelon H Butterhoff, Hieronymus J Derijks, Walter Hermens, Paul D van der Linden

{"title":"Sulfamethoxazole-Trimethoprim-Induced Hyperkalemia in Hospitalized Patients Using Potassium-Sparing Drugs: An Observational Study.","authors":"Madelon H Butterhoff, Hieronymus J Derijks, Walter Hermens, Paul D van der Linden","doi":"10.4140/TCP.n.2024.259","DOIUrl":"10.4140/TCP.n.2024.259","url":null,"abstract":"The objective of this analysis is to investigate the risk of hyperkalemia in hospitalized patients using sulfamethoxazole-trimethoprim (Co-trimoxazole) and a potassium-sparing drug (potassium-sparing diuretic or renin-angiotensin system [RAS]-inhibitor). Researchers conducted a nested case control study within a cohort of hospitalized patients using a potassium-sparing diuretic and/or a RAS-inhibitor from the PHARMO Database Network. Researchers estimated the odds ratios (ORs) and 95% confidence intervals (CI) for the risk of hyperkalemia in patients receiving both Co-trimoxazole and a potassium-sparing drug compared with patients only receiving a potassium-sparing drug. Among a cohort of 25,849 patients, researchers identified 2054 cases of hyperkalemia during hospitalization in patients also using a potassium-sparing drug. Using Co-trimoxazole in addition to a potassium-sparing drug was associated with an increased risk of hyperkalemia in hospitalized patients (ORadj = 1.65, 95% CI 1.26-2.16) compared with using only a potassium-sparing drug. There was a trend of a more pronounced association between hyperkalemia and the co-use of Co-trimoxazole and potassium-sparing drugs in patients with an estimated GFR of 15-29 mL/min (ORadj = 3.15, 95% CI 1.29-7.70). The number needed to harm for hyperkalemia induced by adding Co-trimoxazole to patients receiving a potassium-sparing drug is 19.5. Using the combination of Co-trimoxazole with a potassium-sparing drug in hospitalized patients increases the risk of hyperkalemia compared with using only a potassium-sparing drug. Physicians and other prescribers should be aware of hyperkalemia and routinely monitor serum potassium levels in hospitalized patients using this combination of drugs.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of a Student Pharmacist-Driven Fall-Prevention Program for Older People. 以药剂师学生为主导的老年人防跌倒计划评估。

Senior Care Pharmacist Pub Date : 2024-07-01 DOI: 10.4140/TCP.n.2024.267

Ashley M Lohmann, Leah M Coad, Camryn E Barton, Danielle G Vulcano, Junan Li, Ruth E Emptage

{"title":"Evaluation of a Student Pharmacist-Driven Fall-Prevention Program for Older People.","authors":"Ashley M Lohmann, Leah M Coad, Camryn E Barton, Danielle G Vulcano, Junan Li, Ruth E Emptage","doi":"10.4140/TCP.n.2024.267","DOIUrl":"10.4140/TCP.n.2024.267","url":null,"abstract":"There is limited research on the impact of fall prevention education for older community-living people led by student pharmacists, which includes a medication review to identify Fall Risk-Increasing Drugs (FRIDs). Study objectives were to first assess the knowledge and behavioral intentions of older people after attending a student pharmacist-led fall-prevention program (FPP) and secondly to quantify the number of FRIDs identified during a medication review. Between October 2022 and April 2023, four independent-living facilities and two senior centers served as programming locations. Events began with a fall prevention-focused presentation provided by student pharmacists. Attendees voluntarily filled out surveys to assess their knowledge and behavioral intentions regarding fall prevention. Optional medication reviews were offered. Additional survey questions were asked of medication review participants. If FRIDs were identified, the individual was provided documentation to share with their prescriber. Fall prevention bingo was offered at select events to review educational content and engage those waiting for a medication review. Eighty-six older people attended the presentations; 45 people completed medication reviews across six sites. Survey information was available for 65 presentation attendees and 29 medication review participants. After programming, 64 out of 65 participants stated they felt comfortable speaking to their pharmacist or provider about falls and their medications. Most survey respondents correctly selected which medications increase fall risk. Twenty-two of 29 medication review participants were taking at least one FRID. The FPP described showed positive results through a post-survey evaluation. Participants demonstrated knowledge of fall hazards including medications and a willingness to discuss falls and FRIDs with health professionals. These factors may lead to concrete interventions to avoid falls and their associated health consequences for older people.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0