"iDoctor – Medical Blog"

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 514-550

Virginia, Fleming , William E., Wade

Background: Multiple studies have addressed the treatment of chronic constipation in adults in general; however, less guidance is available for treating this condition in older patients.Objective: The aim of this paper was to review the effectiveness of laxatives for chronic constipation in the elderly.Methods: Medline, Web of Science, international Pharmaceutical Abstracts, and the Cochrane database of Systematic Reviews were searched for english-language articles evaluating the treatment of chronic constipation in older individuals from the inception of the databases until October 2010. Search terms included constipation, treatment, laxative, elderly, and geriatric. Articles were excluded if the mean age was <65 years.Results:…

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 562-570

Seema D., Dedhiya , Emily, Hancock , Bruce A., Craig , Caroline C., Doebbeling , Joseph, Thomas III

Background: Most studies of potentially inappropriate medication (PIM) use among older adults have focused on prevalence rather than incidence.Objectives: The goals of this study were to determine the 1-year incidence of PIM use among elderly Indiana Medicaid residents of nursing homes and to examine associations between incident PIM use and hospitalization and mortality.Methods: A retrospective analysis was conducted using Indiana Medicaid enrollment and administrative claims files. Individuals were included if they were Medicaid eligible and aged ≥65 years as of January 2003 and received nursing home services in each month of 2003 or until death in 2003. Individuals also had…

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 571-582

Andrea, Puig , Sean, McElligott , Henry, Bergquist , Jalpa A., Doshi

Background: The evidence for the benefits of branded levalbuterol over generic albuterol in patients with chronic obstructive pulmonary disease (COPD) is inconclusive. However, there are significant cost differences between these products.Objectives: This study examined use and spending on albuterol and levalbuterol in a nationally representative sample of Medicare beneficiaries with COPD enrolled in Part D in 2006. It also examined differences in patient characteristics and use of other COPD drugs among recipients of these 2 short-acting β-agonists.Methods: Data were obtained from the 5% Medicare files for 2005–2006 linked to the 2006 Medicare Part D files. The sample consisted of all…

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 583-594

Michael A., Steinman , Sneha, Patil , Priya, Kamat , Carolyn, Peterson , Sara J., Knight

Background: Performance-measurement systems may work best when they account for the reasons why physicians do not provide guideline-recommended interventions.Objective: This article develops a conceptual framework for understanding the proximate, patient-centered reasons why physicians do not prescribe angiotensin-converting enzyme (ACE) inhibitors or β-blockers to patients with heart failure and reduced systolic function.Methods: This was a focus group study using a 2-stage design. Academically affiliated clinicians of different specialties and levels of training were recruited by e-mailed invitations sent to clinicians within each target group. To be included, candidates needed to be currently practicing in an ambulatory care setting in which they…

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 599-609

David R.P., Guay

Prosegue la fase di avvio del progetto Inclusive Fitness, presentato in occasione del ForumClub 2010. La recente ratifica, da parte dell’Italia, della Convenzione delle Nazioni Unite sui diritti delle persone con disabilità apre nuovi scenari a vantaggio di una popolazione spesso esclusa dallo sport

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 483-484

Joseph T., Hanlon , Julie, Donohue

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 485-513

Troy D., Kish , Mei H., Chang , Horatio B., Fung

Background: Skin and soft tissue infections (SSTIs) have become the second most common type of infection among persons residing in long-term care facilities.Objective: The purpose of this article was to review the latest information on SSTIs among the elderly, including age-related changes, challenges, and treatment strategies in the era of emerging bacterial resistance.Methods: Relevant information was identified through a search of MEDLINE (1970—April 2010), International Pharmaceutical Abstracts (1970—April 2010), and Google Scholar using the terms skin and soft tissue infection, skin and skin structure infection, cellulitis, treatment guidelines, and elderly. Additional publications were found by searching the reference lists of…

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 551-561

Daryl D., DePestel , Ellie, Hershberger , Kenneth C., Lamp , Preeti N., Malani

Background: Serious gram-positive bacterial infections are an important cause of morbidity and mortality among older adults and can present significant challenges to clinicians. Data evaluating the safety and effectiveness of newer agents in this population are limited.Objective: Daptomycin is a lipopeptide with activity against resistant gram-positive organisms. To better understand the overall safety and effectiveness of daptomycin in older adults (≥66 years of age), the authors reviewed the data that were collected as part of an ongoing registry maintained by Cubist Pharmaceuticals, Inc. (Lexington, Massachusetts), the manufacturer of daptomycin.Methods: The Cubicin Outcomes Registry and Experience (CORE) is a multicenter, retrospective…

Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 6, December 2010, Pages 595-598

Pritish S., Pawar , Douglas A., Woo

Background: Amitriptyline is a tricyclic antidepressant useful for the treatment of depression. Amiodarone is a class III antiarrhythmic agent used for the treatment of cardiac dysrhythmias.Objective: The objective of the current report is to describe the case of a previously asymptomatic patient receiving amitriptyline who developed extrapyramidal symptoms within 1 month of initiating concomitant treatment with amiodarone for atrial fibrillation.Case summary: An 82-year-old, right-handed, white woman was brought to the medical center’s emergency department with speech difficulty suggesting stroke. She was noted to have continuous orobuccal dyskinesias, upper and lower extremity shaking, and dry mouth. Once it was determined that…