The American journal of geriatric pharmacotherapy
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Am J Geriatr Pharmacother · Dec 2009
Pharmacologic management of the older patient with type 2 diabetes mellitus.
Pharmacologic options for the treatment of elderly patients with type 2 diabetes mellitus (T2DM) are the same as in younger adults; however, treatment considerations differ in the elderly due to changes in renal and hepatic function, life expectancy, and various other clinical and practical considerations. ⋯ Overall, there is a scarcity of data regarding the use of pharmacologic agents in older adults with T2DM, and clinical guidance is largely based on data obtained from younger populations. The selection of appropriate drug regimens for these patients remains challenging.
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Am J Geriatr Pharmacother · Dec 2009
National utilization of transdermal fentanyl among community-dwelling older people in Finland.
The use of opioids has increased rapidly in Europe and North America, and older people may be susceptible to opioid-related adverse drug events. The Finnish National Agency for Medicines has recommended that oral opioids be considered the first-line treatment when a strong opioid is required for severe pain. ⋯ The prevalence of transdermal fentanyl use was higher than that of morphine, oxycodone, and hydromorphone among people aged > or = 80 years residing in noninstitutional settings in Finland. The variation in use between hospital districts suggests that organizational culture may have a strong impact on prescribing practices. Our data highlight the need for further education regarding the appropriate use of opioids among older people.
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Am J Geriatr Pharmacother · Oct 2009
Burden of chronic obstructive pulmonary disease in Medicare beneficiaries residing in long-term care facilities.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. COPD increases health care resource utilization and spending and adversely affects quality of life. Data from the clinical and economic outcomes in Medicare beneficiaries with COPD who reside in long-term care (LTC) facilities are limited. ⋯ This study found that the utilization of health care resources and economic burden of LTC residents with COPD were primarily due to LTC, pharmacy, and inpatient costs.
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Am J Geriatr Pharmacother · Oct 2009
ReviewA review of heart failure management in the elderly population.
In the United States, the incidence of heart failure (HF) in the elderly population (age, > or =65 years) approached 10 per 1000 population in 2006, and HF was a common reason for hospitalization. Many clinical features and the management of HF differ in elderly patients compared with their younger counterparts due to changes in physiology and the presence of comorbidities. ⋯ HF therapy that has published mortality and morbidity benefits in nonelderly patient populations has been associated with benefits in elderly patients. Elderly patients may have variable pharmacologic responses to these agents and may be susceptible to adverse events and drug-drug interactions due to concurrent treatments for comorbidities. Close monitoring of elderly patients undergoing HF treatment is essential to ensure optimal outcomes.
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Am J Geriatr Pharmacother · Aug 2009
Case ReportsChorea associated with gabapentin use in an elderly man.
Chorea is a hyperkinetic movement disorder characterized by irregular, flowing, nonstereotyped, random, involuntary movements. Huntington disease (HD) and drug-induced chorea account for >50% of adult-onset cases. Chorea associated with gabapentin, an anticonvulsant, has not been well documented. ⋯ This article reports a case of chorea in an elderly patient who was receiving gabapentin for the treatment of anxiety. After gabapentin discontinuation, the chorea resolved completely, indicating a probable adverse drug reaction.