Side Effects of Drug Therapy in the Elderly

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: closed (30 April 2021) | Viewed by 8511

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Guest Editor
Internal Medicine Department, University Hospital Strasbourg, 67000 Strasbourg, France
Interests: hematological diseases; vitamin B12-related diseases; telemedicine; heart failure prevention; telemonitoring
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Special Issue Information

Dear Colleagues,

Iatrogenia is a very common problem in clinical practice, making it a public health problem. It is said to be responsible for 30% of hospitalizations, particularly impacting the elderly. In this context, knowledge is constantly evolving. A great deal of research is being carried out to try to predict, prevent and treat iatrogenia. Such research is particularly in line with the framework of personalized and participatory medicine. Researchers of all specialties are invited to contribute to this Special Issue concerning the side effects of drug therapy in the elderly.

Dr. Emmanuel Andrès
Guest Editor

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Keywords

  • side effect
  • iatrogenia
  • drug
  • elderly
  • prevention
  • care

Published Papers (2 papers)

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Research

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10 pages, 803 KiB  
Article
Aconitine Neurotoxicity According to Administration Methods
by Ji Yeon Chung, Seung Jae Lee, Hyuck Jin Lee, Jeong Bin Bong, Chan-Hyuk Lee, Byoung-Soo Shin and Hyun Goo Kang
J. Clin. Med. 2021, 10(10), 2149; https://doi.org/10.3390/jcm10102149 - 16 May 2021
Cited by 3 | Viewed by 2762
Abstract
We evaluated the toxic effects of aconitine on the human nervous system and its associated factors, and the general clinical characteristics of patients who visited the emergency room due to aconitine intoxication between 2008 and 2017. We also analyzed the differences related to [...] Read more.
We evaluated the toxic effects of aconitine on the human nervous system and its associated factors, and the general clinical characteristics of patients who visited the emergency room due to aconitine intoxication between 2008 and 2017. We also analyzed the differences related to aconitine processing and administration methods (oral pill, boiled in water, and alcohol-soaked), and the clinical characteristics of consciousness deterioration and neurological symptoms. Of the 41 patients who visited the hospital due to aconitine intoxication, 23 (56.1%) were female, and most were older. Aconitine was mainly used for pain control (28 patients, 68.3%) and taken as oral pills (19 patients, 46%). The patients showed a single symptom or a combination of symptoms; neurological symptoms were the most common (21 patients). All patients who took aconitine after processing with alcohol showed neurological symptoms and a higher prevalence of consciousness deterioration. Neurological symptoms occurred most frequently in patients with aconitine intoxication. Although aconitine intoxication presents with various symptoms, its prognosis may vary with the processing method and prevalence of consciousness deterioration during the early stages. Therefore, the administration method and accompanying symptoms should be comprehensively investigated in patients who have taken aconitine to facilitate prompt and effective treatment and better prognoses. Full article
(This article belongs to the Special Issue Side Effects of Drug Therapy in the Elderly)
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13 pages, 344 KiB  
Review
Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients
by Noel Lorenzo-Villalba, Maria Belen Alonso-Ortiz, Yasmine Maouche, Abrar-Ahmad Zulfiqar and Emmanuel Andrès
J. Clin. Med. 2020, 9(6), 1808; https://doi.org/10.3390/jcm9061808 - 10 Jun 2020
Cited by 10 | Viewed by 4169
Abstract
Agranulocytosis is a rare, but serious and life-threatening hematologic disorder in elderly patients. Idiosyncratic drug-induced agranulocytosis (IDIA) has been classically defined by a neutrophil count below 0.5 × 109/L. The annual incidence of IDIA in Europe is about 1.6–9.2 cases per [...] Read more.
Agranulocytosis is a rare, but serious and life-threatening hematologic disorder in elderly patients. Idiosyncratic drug-induced agranulocytosis (IDIA) has been classically defined by a neutrophil count below 0.5 × 109/L. The annual incidence of IDIA in Europe is about 1.6–9.2 cases per million inhabitants. Increasing age and female sex have been considered as risk factors for the development of this condition. Besides, it is well known that older people take on average more drugs than younger people. This condition is most often associated with the intake of antibacterial agents, antiplatelets, antithyroids, antipsychotics, antiepileptics and nonsteroidal anti-inflammatory drugs (NSAIDs). Initially, agranulocytosis may present without symptoms, but may quickly progress to a severe infection and sepsis. The causative drug should be immediately stopped. In febrile patients, blood cultures and where indicated, site-specific cultures should be obtained and early treatment with empirical broad-spectrum antibiotics started. Even with adequate treatment, the mortality rate is higher in elderly patients reaching up to 20%. Hematopoietic growth factors have proven to be useful as they shorten the duration of neutropenia. However, data on neutropenia and agranulocytosis in the elderly meeting the criteria of evidence-based medicine are still poor in the literature. This review analyzes the results of our experience as well as other published studies of the universal literature. Full article
(This article belongs to the Special Issue Side Effects of Drug Therapy in the Elderly)
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