Polypharmacy in the Aged

Stewart, Ronald B.; Cooper, James W.

doi:10.2165/00002512-199404060-00002

Cited by 138 publications

(28 citation statements)

References 65 publications

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“…The main finding of this retrospective study was that 17 have been important for the probability evaluation was not available retrospectively enhancing the potential for alterations in drug pharmacokinetics, comorbidities and particularly because of multiple drug use [28][29][30][31][32]. misclassification of an event.…”

Section: Number Of Adrs Recognized ( Type a Or B*) Yes Nomentioning

confidence: 99%

Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals

Tegeder

Muth‐Selbach

Oelkers

et al. 1999

Brit J Clinical Pharma

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Aims To estimate the frequency of adverse drug reactions (ADRs) identified through the use of automatic signals generated from laboratory data (ALS) in hospitalised patients. To determine the frequency of spontaneous recognition of these ADRs by the attending physicians and to assess the potential value of ALS for detection of ADRs.Methods Laboratory results of patients hospitalised in a nine bed medical ward were automatically recorded over a period of 17 months. Values exceeding defined boundaries were used as ALS. Charts of every third patient were analysed retrospectively with regard to adverse drug related reactions and causality was evaluated as well as whether the ADR had been recognised during the period of hospitalisation.Results The charts and ALS of 98 patients were analysed. In 18 cases a drug-related adverse reaction was probable. Awareness to the reaction by the treating physicians was evident in 6 out of these 18 ADRs. Approximately 80% of the ADRs were considered predictable. Three ADRs were regarded as serious. Conclusions Adverse drug reactions are common and often preventable. Only one third of ADRs which could have been detected through ALS were recognised by the attending physicians. An increased doctor's awareness of the frequency of drug related abnormal laboratory results by means of ALS is likely to increase the recognition rate of ADRs and might help to prevent them.Keywords: adverse drug reactions, automated laboratory signals stays and substantially add to health care expenditure Introduction [13][14][15]. Thus, health care organisations must maintain ADR surveillance and prevention. At present, most Morbidity due to drugs is common in hospitalised patients although the rate is controversial and varies hospitals rely on spontaneous, voluntary reporting of ADRs by nurses and physicians, however, such systems between 0.7% and 35%, depending on the methods used [1][2][3][4][5][6][7][8]. In a recent meta-analysis of prospective studies the provide limited information [16]. Moreover, physicians may not recognise ADRs even if the appropriate overall frequency of serious ADRs was 6.7% and that of fatal ADRs 0.32% of hospitalised patients [9]. information is in the patient's medical record [17, 18]. The diagnosis of ADRs, especially those that are not Approximately 2-6% of all hospital admissions per year are caused by ADRs [10][11][12]. ADRs can prolong hospital dose-related, is often difficult and agreement in clinical judgements is low (about 50%) both within and between physicians making diagnoses [19, 20]. As a result of this are the adverse reactions probability scale (APS) with 10

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Section: Number Of Adrs Recognized ( Type a Or B*) Yes Nomentioning

confidence: 99%

Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals

Tegeder

Muth‐Selbach

Oelkers

et al. 1999

Brit J Clinical Pharma

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“…Banyak faktor didefinisikan sebagai kondisi yang tidak terkendalikan yang berpengaruh pada terjadinya DRP, faktor yang karena kurangnya obat-obatan, atau kurangnya sinergis terpenting adalah adanya polifarmasi dan peningkatan obat. Obat yang tidak ada indikasi yang jelas akan usia (1)(2)(3). Polifarmasi didefinisikan sebagai pengobatan diklasifikasikan sebagai "terapi obat yang tidak perlu".…”

Section: Pendahuluanunclassified

“…Hal tersebut merupakan salah satu faktor kriteria Beer 2012 untuk mengidentifikasi obat yang predisposisi terjadinya DRP, termasuk efek samping obat, dianggap tidak sesuai untuk digunakan pada pasien usia interaksi obat, ketidakpatuhan pengobatan, terutama lebih dari 60 tahun (10). pada populasi geriatri (1).…”

Section: Pendahuluanunclassified

Permasalahan Pemberian Obat pada Pasien Geriatri di Ruang Perawatan RSUD Saiful Anwar Malang

Rahmawati¹,

Sunarti²

2014

JKB

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ABSTRAKPermasalahan terkait pemberian obat sering terjadi pada pasien yang menjalani perawatan di rumah sakit, dengan faktor risiko yang tersering adalah polifarmasi dan peningkatan usia. Penelitian ditujukan untuk mengetahui deskripsi usia, jenis kelamin, jumlah obat dan prevalensi adanya Permasalahan terkait pemberian obat (Drug Related Problem=DRP) pada pasien geriatri yang menjalani perawatan di Rumah Sakit. Penelitian kohort retrospektif dengan pengambilan data sekunder pada pasien geriatri (≥ 60 thn) di Ruang Perawatan RSUD Saiful Anwar Malang selama Periode JanuariDesember 2011. Penelitian ini menunjukkan dari 150 subjek 55,3% adalah pria, rentang usia 60-65 tahun (28%), 66-70 tahun (36%), 71-75 tahun (19,3%), >75 tahun (16,7%). Polifarmasi terjadi pada 72% pasien geriatri dengan prevalensi kejadian DRP sebesar 72%. Penggunaan obat tersering yaitu antibiotik (73,3%), H2 antagonis (60,7%), antihipertensi (46 %), antiemetik (37,3%), NSAID ( 32%). Kejadian DRP tersering yaitu potensi interaksi obat (66%), dosis yang tidak tepat (17,3%) , pemakaian obat yang tidak perlu (16%), efek samping obat (14%), pemilihan jenis obat yang tidak tepat (8,7%). Potensi interaksi obat terbanyak yaitu pada obat ACE-inhibitor, diuretik dan antiplatelet. Duplikasi obat terjadi pada pemberian PPI dan H2 antagonis. Terdapat hubungan yang signifikan antara peningkatan jumlah obat yang diberikan dengan prevalensi terjadinya DRP (p=0,000). Tidak terdapat hubungan yang signifikan antara peningkatan usia subjek dengan prevalensi DRP (p=0,366). Risiko relatif pasien geriatri dengan polifarmasi mengalami DRP sebesar 1,822 (CI 95%: 1,291-2,569).Kata Kunci: Geriatri, permasalahan terkait pemberian obat, polifarmasi (≥ 60 years) ABSTRACT Drug-related problems often occur in hospitalized patients and the most common risk factors are the presence of polypharmacy and increasing of age. This research aims to determine the description of age, sex, number of drugs and the prevalence of Drug-Related Problems (DRP) in hospitalized geriatric patients. This research is a retrospective cohort study with a secondary data collection in geriatric patients

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“…Thus, the potential for serious pharmacokinetic and pharmacodynamic interactions with drugs, particularly in elderly patients who are susceptible to the consequences of drug interactions, should be a concern. 5) There is little direct information about the pharmacokinetic eŠects of HE on hepatic drug-metabolizing (cyto- chrome p450: CYP) enzymes. Thus, the aim of this study was to clarify the eŠects of HE on the contraction of bladder smooth muscle, pharmacologically relevant receptors in the bladder, hepatic CYP and blood biochemical values in rats.…”

Section: Introductionmentioning

confidence: 99%

Pharmacological Effects of Hachi-mi-jio-gan Extract (Harncare<sup>®</sup>)on the Contractile Response and on Pharmacologically Relevant Receptors in the Rat Bladder

et al. 2009

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Hachi-mi-jio-gan extract (Harncare ; HE), a galenical produced from the traditional Chinese herbal mixture BaWei-Die-Huang-Wan, has been reported to improve lower urinary tract symptoms (LUTS) in patients. The present study was undertaken to clarify the pharmacological eŠects of HE on smooth muscle contraction and on pharmacologically relevant (muscarinic, 1,4-DHP and purinergic) receptors in the rat bladder. Additionally, the eŠects of repeated oral treatment with HE on the hepatic cytochrome P-450 (CYP) and on blood biochemical values in rats were examined. HE (10 mg/ml) inhibited signiˆcantly the acetylcholine-induced contraction of isolated rat bladder strips. The pD 2 value in the absence and presence of HE (10 mg/ml) was 5.14±0.16 and 3.99±0.17, respectively. HE (0.1 to 10 mg /ml) inhibited the speciˆc binding of .23 mg/ml. Based on IC 50 values, the binding activity of HE for purinergic receptors was shown to be signiˆcantly (about 7 times) greater than that for muscarinic and 1,4-DHP receptors. Repeated oral administration of HE (10, 30 and 100 mg/kg/day) for 4 weeks had little or no eŠect on the level and activity of hepatic CYP or on blood biochemical values in rats. In conclusion, the present study has shown that HE exerts signiˆcant binding activity for pharmacologically relevant receptors in the rat bladder and a relaxant eŠect on the acetylcholine-induced contraction of isolated muscle strips. HE seemed to exhibit little pharmacokinetic interaction with drugs.

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Polypharmacy in the Aged

Cited by 138 publications

References 65 publications

Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals

Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals

Permasalahan Pemberian Obat pada Pasien Geriatri di Ruang Perawatan RSUD Saiful Anwar Malang

Pharmacological Effects of Hachi-mi-jio-gan Extract (Harncare<sup>®</sup>)on the Contractile Response and on Pharmacologically Relevant Receptors in the Rat Bladder

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