Deprescribing of proton pump inhibitors in the elderly

Ткачева, О. Н.; Остроумова, О. Д.; Kotovskaya, Yu. V.; Переверзев, А. П.; Krasnov, G.

doi:10.32756/0869-5490-2019-1-70-74

Cited by 4 publications

(2 citation statements)

References 39 publications

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“…Д епрескрайбинг -практика запланированной контро ли руемой отмены, замены и снижения дозы лекар ственных средств (ЛС), он рассматривается как один из методов борьбы с полипрагмазией [1,2].…”

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Treatment of chronic heart failure: is deprescribing possible?

et al. 2020

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Лечение хронической сердечной недостаточности: возможен ли депрескрайбинг? Депрескрайбинг-это практика запланированной отмены, снижения дозы или замены лекарственного средства на более безопасное. В лечении хронической сердечной недостаточности (ХСН) используются одновременно несколько групп лекарственных средств (ЛС), что повышает риск развития нежелательных лекарственных реакций, особенно у пациентов пожилого и старческого возраста. В результате систематического поиска и анализа литературы была оценена возможность депрескрайбинга следующих лекарственных групп: 1) ЛС, влияющие на ренин-ангиотензин-альдостероновую систему, 2) бета-блокаторы, 3) дигоксин, 4) диуретики. Были проанализированы 3 систематических обзора и ряд исследований для определения наиболее возможных и потенциально оптимальных режимов депрескрайбинга при ХСН. Определено, что депрескрайбинг при ХСН имеет крайне ограниченный потенциал применения из-за доказанного очевидного влияния ряда групп ЛС на прогноз и выраженность клинической симптоматики у пациентов с ХСН. Ключевые слова Cердечная недостаточность, пожилой и старческий возраст, депрескрайбинг, полипрагмазия, ингибиторы ангиотензинпревращающего фермента, блокаторы рецепторов к ангиотензину II, бета-блокаторы, диуретики, дигоксин

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“…Как общая концепция, депрескрайбинг может быть представлен в нескольких режимах [2]. 1) Отмена препарата.…”

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Treatment of chronic heart failure: is deprescribing possible?

et al. 2020

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Novel coronavirus infection SARS-CoV-2 in elderly and senile patients: prevention, diagnosis and treatment. Expert Position Paper of the Russian Association of Gerontology and Geriatrics

Ткачева¹,

Kotovskaya²,

Aleksanyan³

et al. 2020

Cardiovasc Ther Prev

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A novel coronavirus infection SARS-CoV-2 (COVID19) is especially dangerous for elderly and senile patients. Preventive measures for elderly people should cover three areas: 1) direct prevention of the viral infection, 2) preservation of the functional status and prevention of geriatric syndromes, including the use of social support measures, 3) control of comorbidities. The clinical pattern of COVID-19 in older patients may be atypical, while the mildness of symptoms (no fever, cough, shortness of breath) may not correspond to the severity of the prognosis. Delirium may be the first manifestation of COVID-19, which requires special care in its screening. Management of elderly and senile patients with COVID19 should include measures for delirium prevention, the detection and improvement of nutrition. The risk of malnutrition with sarcopenia increases with hospitalization of a patient, especially when using artificial ventilation, is associated with an unfavorable prognosis during hospitalization, accelerates the progression of senile asthenia and reduces the quality of life. Geriatric assessment is the cornerstone of determining the management of an elderly patient.

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Is an optimization of the use of proton pump inhibitors feasible in the real world medical practice?

Khomeriki¹,

Khomeriki²

2023

Almanac of Clinical Medicine

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The review deals with the data on negative health impact of prolonged and inadequate use of proton pump inhibitors (PPI). Since their advent at the end of 1980s, their worldwide use has been continuously increasing. However, up to 70% of PPI use is not based on clear indications. Inadequate treatment with PPI not complying with clinical guidelines results in a higher risk of adverse events, especially in the elderly. Prolonged (more than 8 weeks) intake of PPI increases the risk of osteoporotic fractures, promotes Clostridioides difficile infection and gut microbiota abnormalities, community-acquired pneumonia, vitamin B12 deficiency, renal disease, dementia, risk of gastric cancer, etc. Most potential side effects of PPI are the results of hypochlorhydria and reflex hypergastrinemia. The main safety principle for PPI is adherence to short duration of treatment and minimally effective doses. Rational strategies for safe and effective PPI treatment are supported by the evidence-based deprescribing in gastroesophageal reflux disease and include dose tapering or therapy as needed after the treatment course for a specific indication has been finished, or stopping the treatment in patients with no adequate indications to PPI administration. Increased awareness of medical personnel and patients on the proper PPI use and their side effects would make it possible to optimize the use of these agents in the real world medical practice.

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Deprescribing of proton pump inhibitors in the elderly

Cited by 4 publications

References 39 publications

Treatment of chronic heart failure: is deprescribing possible?

Treatment of chronic heart failure: is deprescribing possible?

Novel coronavirus infection SARS-CoV-2 in elderly and senile patients: prevention, diagnosis and treatment. Expert Position Paper of the Russian Association of Gerontology and Geriatrics

Is an optimization of the use of proton pump inhibitors feasible in the real world medical practice?

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