Dr. Andrew Stevens And Addresses Key Areas Of Antineoplastic Drug Therapy

Polypharmacy, described as an individual taking more than four medications, can be concerning with the aging population. Polypharmacy concerns include adverse drug reactions, drug interactions, higher cost, decreased mobility, decreased quality of life and cognition impairment. Those at greater risk of negative polypharmacy consequences include elderly, psychiatric patients, recently hospitalized, individuals with multiple doctors or pharmacies and people with impaired vision or dexterity. There are times that polypharmacy is at times needed to help a person with their diagnosis, an example of this is using multiple medications to treat congestive heart failure which can include digoxin, diuretics, and angiotensin-converting enzyme inhibitors

Hello Professor. I agree that medications are the magic solution to treat diseases if they are used appropriately. For example, when antipsychotic medications are not used correctly could lead to functional decline and cognitive impairment. The health care professionals’ knowledge of safe medication use, risks and benefits, and the drug-related problem are important when taking care of elderly patients. “In 2015, the AGS Beers Criteria were again updated by an expert panel of healthcare and pharmacy experts to help prevent potential medication side effects and other medication-related problems in older adults” (Health in Aging, 2015). It is pivotal to use the guidelines of Beers Criteria in our daily practice to prevent inappropriate use of

Scenario: John is a 4 year-old boy who was admitted for chemotherapy following diagnosis of acute lymphoblastic leukemia (ALL).  He had a white blood cell count of 250,000.  Clinical presentation included loss of appetite, easily bruised, gum bleeding, and fatigue.  Physical examination revealed marked splenomegaly, pale skin color, temperature of 102°F, and upper abdomen tenderness along with nonspecific arthralgia.

Senior citizens are the people who are most likely to take multiple medications due to the occurring chronic conditions as the aging process continues. Given the several medicines they take, they are ironically the age group that is very much sensitive to medication side effects, both therapeutic and negative.

This New York Times article tells a story of overprescribing in the elderly and its consequences on quality life. As pharmacists, we are especially familiar with the physician’s tendency to overprescribe medications in elderly patients with various comorbid conditions. This article brings up a plethora of issues that are common focus points of the geriatric pharmacy course in ACPHS. The use of sedating drugs in which increase the risk of falls and debilitating hip fractures in a population that is already at a high risk for fractures (the elderly) is not only imprudent, but counterproductive to the overall heath outcomes of the patient. The article specially mentions the use of benzodiazepines which are on the BEERs criteria list of medications

Some of these health complications could include hypertension (high blood pressure), heart disease, arthritis, cancer, and diabetes mellitus (also known as Type 2 Diabetes). Common adverse outcomes related to polypharmacy can greatly increase the risk of morbidity and mortality in the geriatric population (2010). An example of these adverse effects could be “any undesirable bodily effects that are a direct response to one or more drugs” caused by either direct effect of a medication or a drug-to-drug reaction (Lilley et al., 2011). Another risk factor regarding polypharmacy is the high chance of falls in the elderly, caused by the high amount of medications being consumed (Sergi et al., 2011). Considering some of the life threatening effects related to polypharmacy in the elderly, this has become a major concern in healthcare. If the elderly had better knowledge of the adverse effects and possible outcomes of polypharmacy, it could potentially decrease these harmful events and lower the chance of morbidity or mortality. This can make us question, what is polypharmacy amongst the geriatric population and how can it be

Immunosuppressive therapy (antithymocyte globulin plus ciclosporin) is associated with response rates of 60-80% with five-

As the population ages, multiple comorbidities result in the use of multiple medications to treat these conditions. The more medications a geriatric patient takes, the greater the risk of nonadherence to the prescribed medication schedule (Frances, Thirumoorthy, and Kwan, 2015). Improper usage of medications results in decreased therapeutic effects and potentially can be dangerous for the patient. Taking too much of a medication can pose as life threatening, while taking too little of a

Adverse drug events occur in fifteen percent or more of the geriatric population that come to offices, hospitals, and long term care facilities. Nearly fifty percent of older adults take one or more

Leukemia refers to a group of cancerous disorders involving the overproduction of abnormal white blood cells in the blood circulation or in the bone. According to Chi & Costeas(2015), the leukocytes are descendants of a single cell that remain unspecialized and multiply out of control, which then harm normal red bone marrow function. In all types of leukemia, cancerous leukocytes fill the red bone marrow and immature white blood cells flood into the bloodstream. The other blood cell lines are pushed out and severe anemia and bleeding problems would follow. High counts of white blood cell would be common (Marieb & Hoehn, 2013). Although there are an enormous amount

When it comes to the topic of cancer, most people readily agree that we have made leaps and bounds in diagnosis and treatment mechanisms. Where this disagreement usually begins, is on the question if finding a “cure” for cancer can be a reality. While some are convinced that a cure will come with time, others believe that a single cure is just not logical. The US waged a war on cancer when Nixon was in office, 1971, yet we haven’t overcome it yet (Gorski). After research, I believe that the disease umbrella known as cancer cannot simply be cured because of it’s overall complexity, variances in causes, the American lifestyle, and the overwhelming associated costs.

The University of Alabama Biomedical Library was searched for relevant studies . This search included COCHRANE Database of Systematic Reviews, OVID database and EBSCO database. Another search was done using Google search, National Guidelines Clearinghouse, and Agency for Health Research. Reviewed articles references were used to obtain more studies. Keywords for all searches included: medication, medication cost, drug, drug cost, elderly, aged, nonadherence, and noncompliance ( See Appendix A). All the studies were less than 5 years old, expert opinions, practice guidelines were reviewed and those related to interventions to assist the elderly with medication cost were selected.

A list of PIMs was developed and published by Beers and colleagues for nursing home residents in 1991 subsequently expanded and revised in 1997, 2003 then 2012 to include all settings of geriatric care [4]. Avoiding the use of inappropriate and high-risk drugs is an important, simple, and effective strategy in reducing medication-related problems (MRP) and ADEs in older adults. However, the use of PIM is common; according to Popovic et al., 62.4% of ageing patients were received at least one medication with risk outweighs the benefit [4].

Thank you MariaChristina for a very informative power point. You have included all the essential topics in the power points. Polypharmacy in older adults is a very relevant topic. Adverse reactions are common in older adults and often manifest differently than in younger patients. An estimated 35% of ambulatory older adults experience an adverse drug reaction each year; 29% of these reactions require hospitalization or a physician’s care and some adverse reactions are identified incorrectly as health problems. For instance, falls, dementia, and urinary incontinence are common in the elderly and can result from a health problem or a medication (Alpert & Gatlin, 2015). The protocol developed based on the evidence that addresses polypharmacy in

The other important point you brought up is that elderly are at increased risk for adverse drug reactions related to pharmacokinetic changes that happen natural due to aging. Some of these changes affect the absorption and metabolism of medications. This can equate to medications having decreased effects or longer half lives.