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      Prurito y diarrea crónicos y polimedicación: optimización de la farmacoterapia tras la intervención farmacéutica Translated title: Chronic pruritus, diarrhea and polymedication: pharmacoterapeutic optimization based on pharmacist’ interventions

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          Abstract

          Resumen La polimedicación se relaciona con la aparición de efectos adversos y problemas relacionados con medicamentos. Presentamos el caso de una paciente pluripatológica y polimedicada en la que tras la revisión del tratamiento por el farmacéutico y sus recomendaciones, se consiguió optimizar la farmacoterapia, reduciendo los problemas relacionados con la medicación y mejorando así su calidad de vida.

          Translated abstract

          Summary Polypharmacy is associated with the occurrence of adverse effects and drug-related problems. We present the case of a frail and polymedicated patient. After reviewing the medication list and the pharmaceutical interventions, pharmacotherapy was optimized, reducing drug-related problems and improving her quality of life.

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          Most cited references8

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          American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.

          (2015)
          The 2015 American Geriatrics Society (AGS) Beers Criteria are presented. Like the 2012 AGS Beers Criteria, they include lists of potentially inappropriate medications to be avoided in older adults. New to the criteria are lists of select drugs that should be avoided or have their dose adjusted based on the individual's kidney function and select drug-drug interactions documented to be associated with harms in older adults. The specific aim was to have a 13-member interdisciplinary panel of experts in geriatric care and pharmacotherapy update the 2012 AGS Beers Criteria using a modified Delphi method to systematically review and grade the evidence and reach a consensus on each existing and new criterion. The process followed an evidence-based approach using Institute of Medicine standards. The 2015 AGS Beers Criteria are applicable to all older adults with the exclusion of those in palliative and hospice care. Careful application of the criteria by health professionals, consumers, payors, and health systems should lead to closer monitoring of drug use in older adults.
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            Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial.

            The optimal duration of treatment of women with postmenopausal osteoporosis is uncertain. To compare the effects of discontinuing alendronate treatment after 5 years vs continuing for 10 years. Randomized, double-blind trial conducted at 10 US clinical centers that participated in the Fracture Intervention Trial (FIT). One thousand ninety-nine postmenopausal women who had been randomized to alendronate in FIT, with a mean of 5 years of prior alendronate treatment. Randomization to alendronate, 5 mg/d (n = 329) or 10 mg/d (n = 333), or placebo (n = 437) for 5 years (1998-2003). The primary outcome measure was total hip bone mineral density (BMD); secondary measures were BMD at other sites and biochemical markers of bone remodeling. An exploratory outcome measure was fracture incidence. Compared with continuing alendronate, switching to placebo for 5 years resulted in declines in BMD at the total hip (-2.4%; 95% confidence interval [CI], -2.9% to -1.8%; P<.001) and spine (-3.7%; 95% CI, -4.5% to -3.0%; P<.001), but mean levels remained at or above pretreatment levels 10 years earlier. Similarly, those discontinuing alendronate had increased serum markers of bone turnover compared with continuing alendronate: 55.6% (P<.001) for C-telopeptide of type 1 collagen, 59.5% (P < .001) for serum n = propeptide of type 1 collagen, and 28.1% (P<.001) for bone-specific alkaline phosphatase, but after 5 years without therapy, bone marker levels remained somewhat below pretreatment levels 10 years earlier. After 5 years, the cumulative risk of nonvertebral fractures (RR, 1.00; 95% CI, 0.76-1.32) was not significantly different between those continuing (19%) and discontinuing (18.9%) alendronate. Among those who continued, there was a significantly lower risk of clinically recognized vertebral fractures (5.3% for placebo and 2.4% for alendronate; RR, 0.45; 95% CI, 0.24-0.85) but no significant reduction in morphometric vertebral fractures (11.3% for placebo and 9.8% for alendronate; RR, 0.86; 95% CI, 0.60-1.22). A small sample of 18 transilial bone biopsies did not show any qualitative abnormalities, with bone turnover (double labeling) seen in all specimens. Women who discontinued alendronate after 5 years showed a moderate decline in BMD and a gradual rise in biochemical markers but no higher fracture risk other than for clinical vertebral fractures compared with those who continued alendronate. These results suggest that for many women, discontinuation of alendronate for up to 5 years does not appear to significantly increase fracture risk. However, women at very high risk of clinical vertebral fractures may benefit by continuing beyond 5 years. clinicaltrials.gov Identifier: NCT 00398931.
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              Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial

              Although statins reduce coronary and cerebrovascular morbidity and mortality in middle-aged individuals, their efficacy and safety in elderly people is not fully established. Our aim was to test the benefits of pravastatin treatment in an elderly cohort of men and women with, or at high risk of developing, cardiovascular disease and stroke.
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                Author and article information

                Journal
                ofil
                Revista de la OFIL
                Rev. OFIL·ILAPHAR
                Organización de Farmacéuticos Ibero-Latinoamericanos (Madrid, Madrid, Spain )
                1131-9429
                1699-714X
                2021
                : 31
                : 1
                : 105-107
                Affiliations
                [1] orgnameServicio Navarro de Salud orgdiv1Subdirección de Farmacia orgdiv2Servicio de Asesoría e Información del Medicamento España
                Article
                S1699-714X2021000100018 S1699-714X(21)03100100018
                10.4321/s1699-714x20210001000018
                da3d9df2-4c70-4a5b-a4e5-9ab1ec308578

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 19 December 2019
                : 29 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 3
                Product

                SciELO Spain

                Categories
                Casos Clínicos

                Drugs-related problems,intervención farmacéutica,pluripatología,polifarmacia,Problema relacionado con el medicamento,pharmaceutical intervention,frailty,polypharmacy

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