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Related Concept Videos

Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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Drug Dosing: Geriatric Patients01:15

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Drug toxicity: Drug–Drug Interaction01:30

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Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
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Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
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Drug Therapy01:28

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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Diagonal Method to Measure Synergy Among Any Number of Drugs
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Polypharmacy-an Upward Trend with Unpredictable Effects.

Dirk Moßhammer1, Hannah Haumann, Klaus Mörike

  • 1Joint first authors, Institute for General Medicine and Inter professional Care, Tübingen University Hospital, Tübingen, Department of Clinical Pharmacology, Tübingen University Hospital, Tübingen.

Deutsches Arzteblatt International
|October 16, 2016
PubMed
Summary
This summary is machine-generated.

Polypharmacy, the use of multiple drugs, affects many elderly patients. While tools exist to manage medication, their impact on clinical outcomes like mortality remains unclear, necessitating individualized treatment decisions.

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Area of Science:

  • Geriatric Medicine
  • Clinical Pharmacology
  • General Practice

Background:

  • Guideline-oriented treatments often lead to polypharmacy, primarily affecting elderly individuals.
  • Polypharmacy involves the simultaneous long-term use of multiple medications.
  • This review examines scientific evidence on polypharmacy, focusing on clinical endpoints and implications for practice.

Purpose of the Study:

  • To survey current scientific evidence regarding polypharmacy.
  • To focus on the impact of polypharmacy on clinical endpoints.
  • To identify implications for medical practice and future research.

Main Methods:

  • A selective literature review was conducted.
  • The search utilized PubMed with terms 'polypharmacy AND general practice'.
  • Pertinent publications and selected references were included.

Main Results:

  • Polypharmacy affects approximately 42% of Germans over 65, with a rising trend.
  • 20-25% of these patients receive potentially inappropriate medications.
  • Evidence linking polypharmacy directly to mortality is inconsistent; distinguishing its effect from multimorbidity is challenging.
  • Tools like PRISCUS, FORTA, MAI, and specific guidelines can assist physicians, but their impact on outcomes is unproven.

Conclusions:

  • Individualized treatment decisions are crucial for managing polypharmacy, considering current goals.
  • Drug lists and guidelines can aid physicians in medication management.
  • Future research and guidelines should emphasize multimorbidity and polypharmacy.