The American journal of geriatric pharmacotherapy
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Am J Geriatr Pharmacother · Jun 2008
Case ReportsAdverse effects of propafenone after long-term therapy with the addition of citalopram.
Propafenone, a class IC antiarrhythmic, and citalopram, a selective serotonin reuptake inhibitor (SSRI), are widely used in older patients. Although a potential interaction between propafenone and SSRIs has been noted, a MEDLINE search revealed no published reports of an interaction between propafenone and citalopram. ⋯ This is the first report of a possible interaction between propafenone and citalopram, which caused propafenone adverse effects (eg, dizziness, falls) and mimicked coronary artery disease.
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Am J Geriatr Pharmacother · Dec 2007
ReviewPharmacologic prevention of aspiration pneumonia: a systematic review.
Aspiration pneumonia is a common cause of morbidity and mortality. Several approaches, including bed positioning, dietary changes, and oral hygiene, have been proposed to prevent aspiration pneumonia, yet few data are available on the efficacy of pharmacologic interventions in reducing the rate of aspiration. ⋯ Limited information is available on benefits and risks to guide an evidence-based approach to the pharmacologic prevention of aspiration pneumonia. Considering the high incidence of aspiration pneumonia in older adults, large randomized clinical trials on the effectiveness of pharmacologic interventions are warranted.
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Polypharmacy is a significant problem among older adults. Patient-related characteristics and beliefs have not been the focus of prior research in this area, which has primarily evaluated the effects of patients' health status and health care system factors. ⋯ We found a very high prevalence of unnecessary drug use in this older veteran outpatient population. Race, income, and polypharmacy, as well as health-related beliefs, were central factors associated with unnecessary drug use.
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Older individuals experience physiologic changes in organ function related to aging or to specific disease processes. These changes can affect drug pharmacodynamics in older adults. ⋯ There is a general trend of greater pharmacodynamic sensitivity in the elderly; however, this is not universal, and these age-related changes must be investigated agent-by-agent until further research yields greater understanding of the molecular mechanisms underlying the aging process.