Drug/Natural Products-Related problems in Elderly

Zailani, Izni Syahirah; Moshawih, Said; Kifli, Nurolaini; Wahab, Mohd Shahezwan Abd; Lee, Kah Seng; Ming, Long Chiau

doi:10.36877/pddbs.a0000312

Cited by 3 publications

(1 citation statement)

References 36 publications

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“…CKD patients are particularly vulnerable to the substantial accumulation of drugs that are excreted through the renal route [37,38] , which is especially pertinent among older people [39] . Incorrect medication dosages can lead to severe complications for CKD patients, encompassing morbidity, extended hospital stays, and even mortality [37,40] .…”

Section: Introductionmentioning

confidence: 99%

Assessment of Inappropriate Dose Adjustment of Antimicrobials and Other Medicines Among Chronic Kidney Disease Patients: A Multicenter Observational Study

Zafar,

Ur Rehman,

Shah

et al. 2023

Prog Micobes Mol Biol

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Most drugs undergo metabolism and elimination primarily by the kidneys. Consequently, drug dosages are largely contingent upon kidney function and require careful adjustment in patients with compromised renal function. Inaccurate dosage adjustments can lead to toxicities, therapeutic failures, and adverse drug reactions. This study sought to assess the appropriateness of dose adjustments for antimicrobials and other medicines among patients with Chronic Kidney Disease (CKD) attending both a public and a private hospital. A multicenter, retrospective observational study was carried out from January 1st to February 28th, 2023, among hospitalized CKD patients in two distinct facilities: Northwest General Hospital & Research Centre (a private institution) and the Institute of Kidney Diseases, Peshawar, Pakistan (a public institution). The goal was to compare adherence to dosing guidelines and to identify factors contributing to incorrect renal dose adjustments for antimicrobials and other medications. The study incorporated 358 CKD patients, with 179 patients from each hospital. Medications necessitating dosage adjustments were more frequently prescribed in the private hospital (n=515) compared to the public one (n=368). Nonetheless, dosages were more accurately adjusted in the private hospital (52.6%) than in the public hospital (40.5%). Of all the prescribed medications, 71.1% of antimicrobials in both hospitals were inaccurately adjusted. Multivariate logistic regression analysis showed that the number of drugs requiring adjustment (AOR=0.6; p=0.001) was independently correlated with inappropriate drug adjustments in the private hospital. Conversely, in the public hospital, both the number of drugs requiring adjustment (AOR=0.6; p=0.019) and the length of hospital stay (AOR=0.8; p=0.048) were independently linked with inappropriate drug adjustments. The research revealed that a significant number of hospitalized CKD patients receive inappropriate drug dosages, especially in public hospitals. This predisposes these patients to heightened risks, including therapeutic failure.

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Section: Introductionmentioning

confidence: 99%

Assessment of Inappropriate Dose Adjustment of Antimicrobials and Other Medicines Among Chronic Kidney Disease Patients: A Multicenter Observational Study

Zafar,

Ur Rehman,

Shah

et al. 2023

Prog Micobes Mol Biol

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A Comprehensive Review on the Ethnopharmacological Potential of <i>Inula racemosa</i>

Baile,

Parmar

2024

JNR

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Inula racemosa, Pushkarmool or Indian elecampane, is a perennial herbaceous plant indigenous to the Himalayan region and various parts of Central Asia. It is classified within the Asteraceae family and is characterised by its tall stature, prominent foliage, and clusters of yellow blossoms. It has traditionally been a staple in Ayurvedic medicine due to its multifaceted therapeutic attributes, including expectorant, diuretic, and anti-inflammatory properties. Through chemical analysis, key bioactive constituents such as alantolactone and isoalantolactone have been identified, underscoring their medicinal significance. Emerging research underscores the potential of I. racemosa extracts in addressing respiratory disorders, gastrointestinal maladies, and inflammatory ailments. Nevertheless, comprehensive investigations are imperative to delineate its pharmacological mechanisms and potential adverse reactions.

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Reducing Herb-Drug Interaction Risks: A Clinical Decision Support System for Community Pharmacy (Preprint)

Martins,

Costa,

Maia

et al. 2023

Preprint

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BACKGROUND Herbal medicines have been used for centuries and are still widely used as alternative or complementary therapies for several conditions. However, the use of these products has raised concerns about their safety, particularly about interactions with conventional drugs, known as herb-drug interactions. OBJECTIVE In this paper, we showcase the ForPharmacy Decision Support System, designed to identify herb-drug interactions. With this system, pharmacists could effectively utilize scientific information, including randomized controlled trials, non-randomized trials, retrospective studies, and case reports, and convert it into practical knowledge for individual patients. METHODS The knowledge-based of ForPharmacy Decision Support System was built by conducting a literature review performed in English, using 3 electronic databases: PubMed, Scopus, and Web of Science, including studies conducted with human beings with no restriction of age, gender or disease. The search focused on herb/plant-drug interactions and included both studies with interactions and with no found interactions. The results allowedconstructing a corresponding knowledge database that feeds the ForPharmacy expert system. Additionally, a user-friendly interface was designed for an easy and efficient access and utilization of the system in an intuitive manner. RESULTS The ForPharmacy Decision Support System assists pharmacists in quickly and efficiently identifying herb-drug interactions. Its knowledge base is composed by a total of 187 interactions involving various herbs. The most frequent herb associated with drug interaction was St. John's Wort, accounting for 10.7% of the interactions, followed by Ginkgo (4.5%), Ginseng (3.6%), and Milk Thistle (3.6%). With respect to drugs, bupropion exhibited the highest probability of interactions, with a percentage of 13.37%, followed by dextromethorphan (11.8%) and warfarin (11.2%). This system offers pharmacists a user-friendly interface, which allows them to identify interactions between a particular drug and herb, or obtain a list of all potential interactions for a specific drug. Additionally, the system provides comprehensive details on the common symptoms associated with each interaction, along with the potential danger and significance value. CONCLUSIONS Our research provides a valuable contribution to the field of herb-drug interactions, as it offers a new Decision Support System that can effectively identify potential interactions and associated symptoms. The system's user-friendly interface and distinct use cases make it a practical tool for healthcare professionals and patients. Future work should focus on expanding the knowledge base to facilitate the application of machine learning models. This would allow autonomous identification of new interactions, thereby enhancing the system's ability to identify novel interactions. Our findings underscore the significance of ongoing research in this area to advance patient safety and prevent adverse events.

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Drug/Natural Products-Related problems in Elderly

Cited by 3 publications

References 36 publications

Assessment of Inappropriate Dose Adjustment of Antimicrobials and Other Medicines Among Chronic Kidney Disease Patients: A Multicenter Observational Study

Assessment of Inappropriate Dose Adjustment of Antimicrobials and Other Medicines Among Chronic Kidney Disease Patients: A Multicenter Observational Study

A Comprehensive Review on the Ethnopharmacological Potential of <i>Inula racemosa</i>

Reducing Herb-Drug Interaction Risks: A Clinical Decision Support System for Community Pharmacy (Preprint)

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