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- Danielsson, B., et al.
(författare)
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Drug use and torsades de pointes cardiac arrhythmias in Sweden: a nationwide register-based cohort study
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study the occurrence of torsades de pointes (TdP) ventricular tachycardia in relation to use of drugs labelled with TdP risk, using two nationwide Swedish registers. Design Prospective register-based cohort study. Setting Entire Sweden. Participants Persons aged >= 18 years prescribed and dispensed any drug classified with TdP risk during 2006-2017, according to CredibleMeds. Persons with a registered TdP diagnosis during the study period, using drugs labelled with known (TdP 1), possible (TdP 2) or conditional (TdP 3) risk at the incident of TdP were examined. Primary outcome measures Occurrence of TdP in relation to exposure rates for individual drugs with TdP risk. Secondary outcome measures Concurrent use of more than one TdP-labelled drug in a person with a TdP diagnosis. Results During the study period, 410 TdP cases using drugs with TdP risk labels at the incident were registered; 205 women and 205 men, mean age 74.0 and 71.5 years, respectively. Antidepressants dominated (129/410, 30%), followed by antiarrhythmics (17%). Diuretics and gastric acid-secretion inhibitors, with TdP risk related to induction of hypokalaemia or hypomagnesaemia, were used in 56% and 32% of the 410 TdP cases, respectively. Among the most used antidepressants, citalopram with known TdP 1 risk was associated with both a higher absolute number and incidence of TdP per 100 000 users (two to four times), compared with mirtazapine with possible (TdP 2), and sertraline with conditional (TdP 3) risk. Multiple risk factors, including advanced age, cardiovascular disease and treatment with more than one TdP-classified drug, were frequently observed. Conclusions Antidepressants followed by antiarrhythmics dominated among TdP risk drugs used by adults with TdP diagnosis, the majority being >= 65 years. TdP risk class and concomitant medication should be considered when prescribing antidepressants to older patients.
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- Beckman, A, et al.
(författare)
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The difficulty of opening medicine containers in old age : a population-based study
- 2005
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Ingår i: Pharmacy World & Science. - : Springer Science and Business Media LLC. - 0928-1231 .- 1573-739X. ; 27:5, s. 393-398
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate elderly people's ability to open medicine containers, and how this ability correlates to some common disorders that may cause functional or cognitive impairment. Methods: Cross-sectional study of older people age 81 years and older, from the second follow-up (1994-1996) of the Kungsholmen project, a population based study of very old people in an urban area of Stockholm, Sweden. Six hundred and four persons (mean age 86.7 years) were tested for their ability to open three types of medicine containers. The disorders studied were rheumatoid arthritis, stroke, Parkinson's disease, cognitive impairment (measured by mini-mental state examination, MMSE) and impaired vision. Results: We found that 14% were unable to open a screw cap bottle, 32% a bottle with a snap lid, and 10% a blister pack. Female gender, higher age, living in an institution, Parkinson's disease, rheumatoid arthritis, cognitive impairment and impaired vision were all associated with a decreased ability to open the containers. Less than half of the elderly people who were unable to open one or more of the containers received help with their medication. Among those living in their own homes only 27% received help. Conclusion: Older peoples' ability to open medicine containers is impaired by several conditions affecting physical and cognitive functioning. Many elderly people who are unable to open medicine containers do not receive help with their medication, particularly those living in their own homes.
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- Björkman, Ingeborg, et al.
(författare)
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Drug-drug interactions in the elderly
- 2002
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Ingår i: The Annals of pharmacotherapy. - 1060-0280 .- 1542-6270. ; 36:11, s. 1675-1681
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Tidskriftsartikel (refereegranskat)
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