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- Björkman Lundberg, Kerstin, et al.
(författare)
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Compliance to National Guidelines for Pharmaceutical Treatment of Sleeping Disorders among Elderly Incident Patients in Sweden in PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, vol 20, issue , pp S203-S203
- 2011
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Ingår i: PHARMACOEPIDEMIOLOGY AND DRUG SAFETY. - : John Wiley and Sons. ; , s. S203-S203
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Konferensbidrag (refereegranskat)abstract
- Background:National guidelines for pharmaceutical treatmentof sleeping disorders among elderly state that zopicloneshould be the first choice and that other hypnotics,such as long acting benzodiazepines and propiomazine,should be avoided. According to aggregated data describingprevalent users compliance to guidelines is fairly high. Objectives:The objective of this study was to investigatechoice and volume (DDD) of substance among incidentusers 75 years and older (75+) of hypnotics (N05C) in Swedenand compare between different county councils andwith incident users below 75 years of age. Methods:Data from the Swedish Prescribed Drug registercovering all dispensed prescriptions in Sweden was analyzedfor incident users of hypnotics (15–44, 45–64, 65–74 and 75+ years of age). Incident users were defined aspeople who filled a prescription (index date) of a hypnotic(N05C) during the period December 2009 - November2010 and had not filled any prescription for a hypnotic duringa wash-out period of 24 months before the index date. Results:Among incident patients 75+ (n= 38,620) zopiclone(52.9%), zolpidem (25.4%), and propiomazine(10.4%) were the most frequently used hypnotics. Therewere however differences between different county councilsin Sweden, with zopiclone ranging from 30 % to 68 %. Theincidence for recommended and appropriate hypnoticsincreased with increasing age, whereas the incidence ofinappropriate hypnotics did not. The prescribed volume ofinappropriate hypnotics was generally larger than the prescribedvolume of recommended hypnotics. Conclusions:The compliance to current guidelines onchoice of hypnotics for the elderly is fairly good, althoughthere is considerable variation between county councils.There are tendencies towards larger mean volumes of inappropriatehypnotics, although further studies are needed toconfirm these findings. Another aspect of quality in treatmentwith sleeping agents is to which extent incident userscontinue their treatment and for how long. This is an issuefor further research.
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| 4. |
- Eriksson, Andreas C, et al.
(författare)
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Adhesion of human platelets to albumin is synergistically increased by lysophosphatidic acid and adrenaline in a donor-dependent fashion
- 2006
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Ingår i: Blood Coagulation and Fibrinolysis. - : Ovid Technologies (Wolters Kluwer Health). - 0957-5235 .- 1473-5733. ; 17:5, s. 359-368
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Tidskriftsartikel (refereegranskat)abstract
- Lysophosphatidic acid (LPA) and adrenaline are weak platelet activators considered important for thrombus formation, and were previously shown to synergistically increase platelet aggregation. Here we investigate synergistic activation by LPA and adrenaline when measuring platelet adhesion. Platelet-rich plasma from healthy blood donors together with adrenaline and/or LPA were added to protein-coated microplates. Platelets were allowed to adhere and the amount of adhesion detected enzymatically. The LPA and adrenaline combination induced a synergistic increase of platelet adhesion to a normally non-adhesive albumin surface. The degree of synergy varied markedly between individuals; these variations could not be explained by age, gender, blood type or different amounts of platelets, oxidized low-density lipoprotein, insulin or glucose in plasma. There was a trend indicating increased synergistic effect for platelets sensitive to adrenaline stimulation. The synergistic effect was blocked by the α2-adrenoceptor antagonist yohimbine and inhibited by the ADP scavenger system creatine phosphate/creatine phosphokinase and antibodies against αIIbβ3. Furthermore, platelets adhering to albumin after adrenaline and LPA treatment expressed P-selectin. In conclusion, LPA and adrenaline act synergistically to increase αIIbβ3-mediated platelet adhesion to albumin, dependent on α2-adrenoceptor signalling and platelet secretion. We also confirm that synergistic platelet activation achieved with LPA and adrenaline is highly donor dependent.
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