Preventable and Non-Preventable Risk Factors for Adverse Drug Events Related to Hospital Admissions in the Elderly

Doucet, J.; Jego, A.; Noël, David; Geffroy, Charles-Emmanuel; Capet, C.; Coquard, A.; Couffin, E; Fauchais, Anne‐Laure; Chassagne, Pierre; Mouton-Schleifer, D; Bercoff, É.

doi:10.2165/00044011-200222060-00006

Cited by 65 publications

(52 citation statements)

References 31 publications

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“…Such therapy can result in patient hospitalization due to adverse drug interactions manifested as a loss in therapeutic efficacy or acute toxicity of a drug, caused by a coadministered drug (Doucet et al, 2002). Changes in rates of in vivo metabolism because of induction or inhibition of drug-metabolizing enzymes can cause drug concentrations to fall outside their therapeutic window (Hempel and Klinger, 1976;Fuhr, 2000).…”

mentioning

confidence: 99%

In Vitro Drug Interactions of Cytochrome P450: An Evaluation of Fluorogenic to Conventional Substrates

Cohen¹,

Remley²,

Raunig³

et al. 2003

Drug Metab Dispos

124

109

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This article is available online at http://dmd.aspetjournals.org ABSTRACT:Clinically observed drug interactions with cytochrome P450 (P450) enzymes have increased the need to assess drug interactions of new chemical entities early in the discovery process. To meet this need, fluorogenic substrates have been commercialized. However, only limited evaluations of their utility and comparisons to drug probes have been reported. This study examines the correlation between IC 50 values obtained with fluorogenic and conventional drug probes for structurally diverse inhibitors of the five major human P450 isoforms. In general, correlations are weak, with significant numbers of compounds being missed as inhibitors by either probe. For P450s 1A2, 2C9, and 2C19, correlation coefficients were above 0.6 with slopes that ranged from 1.5 to 4.2.However, for P450s 1A2 and 2C9, about 20% of compounds were not included because an IC 50 value could not be determined with one of the two probes. CYP 2C19 had the highest correlation (correlation coefficient 0.84), with a slope of 2.0 and less than 5% of compounds excluded. CYP 2D6 showed a good correlation for IC 50 values less than 10 M. However, at higher IC 50 values, a high degree of scatter was observed. CYP 3A4 had the weakest correlation, and a large number of compounds were excluded with the fluorogenic probe. Overall, the study shows the care needed when selecting fluorogenic probes and the caution needed when results with fluorogenic probes are used to drive structure-activity relationships with respect to drug interactions.

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mentioning

confidence: 99%

In Vitro Drug Interactions of Cytochrome P450: An Evaluation of Fluorogenic to Conventional Substrates

Cohen¹,

Remley²,

Raunig³

et al. 2003

Drug Metab Dispos

124

109

View full text Add to dashboard Cite

show abstract

“…A high proportion (> 50%) of iatrogenesis in the elderly is deemed avoidable. [7] While medicines are useful overall in patients aged more than 80 years, their appropriate use requires both some general and specific precautions, depending on the health of the individual patient. However, analysis of drug consumption in this population shows that both drug prescribing and utilisation are inappropriate.…”

Section: The Riskmentioning

confidence: 99%

Appropriate Medication Use in Individuals Aged 80 or More Years

Marquet¹,

Deguines

Juillet³

2005

Therapies

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Over the last few years, there has been a rapid and steadily expanding demographic explosion in the elderly population in France. When the most dynamic segment of this growth is considered, i.e. patients aged 80 years or more (who, moreover, usually have several diseases), under-or over-prescribing and/or inappropriate prescribing are identified. Three short-and medium-term recommendations are proposed: to quickly get expert consensus on the theme of prescribing for the aged patient; to integrate systematic drug re-evaluation into annual consultations for people aged 80 years or more; and to better coordinate actions and communication between institutions, health professionals and the pharmaceutical industry.

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“…Une proportion importante (> 50 %) de cette iatrogénèse est considérée comme évitable. [7] Si le médicament est avant tout utile à cette population de malades de plus de 80 ans, son utilisation doit répondre, pour garantir le bon usage, à un certain nombre de précautions générales et particulières en fonction de l'état de santé de chaque malade. Les analyses des médicaments consommés dans cette population montrent d'ailleurs l'existence trop fréquente de prescriptions et d'utilisations inadéquates.…”

Section: Les Risques Encourusunclassified

Le bon usage du médicament chez le sujet âgé de 80 ans et plus

Marquet¹,

Deguines

Juillet³

et al. 2005

Therapies

Self Cite

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RésuméL'explosion démographique des sujets âgés en France est en pleine et durable expansion depuis quelques années. Si on s'intéresse au segment le plus dynamique de cette croissance, à savoir plus particulièrement les patients âgés de 80 ans et plus, par ailleurs le plus souvent polypathologiques, on identifie fréquemment soit une sous-prescription, soit une surprescription et/ou une prescription inappropriée. Trois recommandations à court et moyen terme ont été proposées : obtenir rapidement des consensus d'experts sur le thème de la prescription chez le sujet âgé, intégrer la réévaluation systématique des médicaments dans des consultations annuelles pour les 80 ans et plus, mieux coordonner les actions et la communication entre les institutions, les professionnels de santé et l'Industrie. Mots clés : bon usage, médicament, iatrogénèse, sujet âgé PHARMACOLOGIE CLINIQUE

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Preventable and Non-Preventable Risk Factors for Adverse Drug Events Related to Hospital Admissions in the Elderly

Cited by 65 publications

References 31 publications

In Vitro Drug Interactions of Cytochrome P450: An Evaluation of Fluorogenic to Conventional Substrates

In Vitro Drug Interactions of Cytochrome P450: An Evaluation of Fluorogenic to Conventional Substrates

Appropriate Medication Use in Individuals Aged 80 or More Years

Le bon usage du médicament chez le sujet âgé de 80 ans et plus

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