Pharmacists providing care for older individuals should familiarize themselves with the 2015 American Geriatrics Society Beers Requirements. In a program at the 2015 American Culture of Consultant Pharmacists Annual Getting together with and Exhibition in Las Vegas, Nevada, panelists described that the new drug-drug interaction table in the updated Beers Criteria isn’t intended to be extensive because such a list would be too long. There are a complete large amount of drug-drug interactions, but we’ve narrowed this list down to clinically meaningful and impactful information, incoming ASCP president Nicole Brandt, PharmD, MBA, CGP, BCPP, FASCP, told session attendees levitra price . AGS Beers Criteria panel co-seat Todd Sempla, MS, PharmD, BCPS, FCCP, AGSF, exclusively told Pharmacy Situations that pharmacists will have to explain [the changes] to the prescribers and the teams that they work with. He also mentioned that pharmacists may have a steeper learning curve if indeed they haven’t adopted the Beers Requirements to their practices previously. The following object drugs and drug classes were included in the fresh drug-drug interaction component of the 2015 Beers Criteria: Continue Reading >> 1. Peripheral Alpha-1 Blockers Interacting Drug/Class: Loop diuretics Rationale: Conversation has been proven to increase the chance of bladder control problems in older women. Recommendation: Avoid in old women, unless conditions warrant their concurrent make use of. READ ON >> 2. Angiotensin-Converting Enzyme Inhibitors Interacting Drug/Class: Amiloride or triamterene Rationale: Interaction can increase the risk of hyperkalemia. Recommendation: Avoid routine make use of and reserve for sufferers with known and demonstrated hypokalemia while on an ACE inhibitor. Craig Cocchio, PharmD, BCPS, previously wrote a sense of the severe nature of this interaction has been recently renewed after previously being overlooked due to some degree of alert fatigue. READ ON >> 3. Anticholinergics Interacting Drug/Class: Anticholinergics Rationale: Interaction increases the risk of cognitive decline. Recommendation: Avoid or minimize the number of anticholinergic agents. Dementia is a huge public concern, and there are a growing number of adults with the problem, Dr. Brandt told program attendees. Too often, we are not searching at the anticholinergic burden when analyzing patients. Continue Reading >> 4. Antidepressants, Antipsychotics, Benzodiazepines, and Benzodiazepine-Receptor Agonists Interacting Drug/Class: Several central nervous program drugs Rationale: Interaction has been shown to increase the chance of falls. Recommendation: Avoid 3 or more CNS drugs, and minimize the true number of CNS medications. Of the 20 most prescribed drugs commonly, 10 medications—3 which influence the central nervous program—increase the risk of accidental injuries from falling significantly. The best risk was seen with the opioids and antidepressants. I hear all too often that in ICU units people are using prophylactic antipsychotics, Dr. Brandt lamented. Individuals who make protocols at hospitals aren’t people who are been trained in geriatrics often. Dr. Semla solely told Pharmacy Moments that previous Beers Criteria explained benzodiazepines and benzodiazepine-receptor agonists as okay for use for 90 days. We actually got that off and said there is no acceptable duration useful due to their increased risk of dropping and cognitive impairment, Dr. Semla said. Continue Reading >> 5. Corticosteroids Interacting Drug/Class: non-steroidal anti-inflammatory drugs Rationale: Conversation has been proven to increase the chance of peptic ulcer disease or gastrointestinal bleed. Recommendation: Avoid, but if that’s extremely hard some GI protective agent should be provided then. Patients receiving this combination should be counseled to watch for signs of [top gastrointestinal] bleeding, John R. Horn, Wrote PharmDpreviously. The administration of acid suppressants should be considered in these patients, particularly if the patient has a history of GI bleeding or ulceration. Continue Reading >> 6. Lithium Interacting Drug/Class: ACE inhibitors and loop diuretics Rationale: Both drug classes have already been associated with an elevated risk of toxicity when interacting with lithium. Recommendation: Avoid when possible, however when it’s not, lithium concentrations ought to be closely monitored.
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