Potential Adverse Drug Events with Tetrahydrocannabinol (THC) Due to Drug–Drug Interactions

Journal of Clinical Medicine, Год журнала: 2020, Номер 9(4), С. 919 - 919

Опубликована: Март 27, 2020

Tetrahydrocannabinol (THC) is the primary psychoactive ingredient in cannabis. While safety of THC and cannabis has been extrapolated from millennia recreational use, medical marijuana programs have increased exposure among medically complex individuals with comorbid conditions many co-prescribed medications. Thus, should be recognized as a pharmacologically compound potential for drug–drug interactions adverse drug events. This review summarizes events related to when combined other Metabolic are primarily due conversion by CYP3A4 CYP2C9, which can impacted several common Further, CYP2C9 polymorphisms highly prevalent certain racial groups (up 35% Caucasians) increase bioavailability THC. also broad drug-metabolizing enzymes enhance effects Pharmacodynamic include neurological effects, impact on cardiovascular system, risk infection. General clinical recommendations use starting low doses titrating desired effects. However, may unavoidable, dose-limiting, or barrier THC-based therapy. Future work research must establish sufficient data resources capture such studies. Meanwhile, clinicians balance risks lack strong evidence efficacy patient desires alternative

Язык: Английский

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Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models

Drugs & Aging, Год журнала: 2021, Номер 38(11), С. 977 - 994

Опубликована: Ноя. 1, 2021

Patients taking medication with high anticholinergic and sedative properties are at increased risk of experiencing poor cognitive physical outcomes. Therefore, precise quantification the cumulative burden their drug regimen is advisable. There no agreement regarding which scale to use simultaneously quantify associated medications. The objective this review was assess strengths limitations available tools medication-related load in older adults. We discuss specific agreements between currently scales models propose a comprehensive table combining drugs categorized as high, moderate, low, or activity excerpted from selected studies. A targeted search carried out using National Library Medicine through PubMed medical subject heading terms text words around following terms: (anticholinergic OR sedative) AND (load scale) for studies published 1 January 1945 5 June 2021. In addition, databases were searched same MEDLINE-EBSCO, APA PsycInfo, CINAHL Plus, Cochrane Library, Scopus, OAIster, OVID-MEDLINE, Web Science, Google Scholar. Screening by titles followed an abstract full-text review. After blind evaluation, reviewers reached establish characteristics categories. 3163 articles identified, 13 included: 11 assigned scores two drugs. Considerable variability observed; included 27 548 generated activities evaluated proposed categorization these based on scientific clinical evidence. Our combines information about 642 categorizes 44, 25, 99, 474 activity, respectively. Variability inconsistency exists among used categorize burden. review, we provide that proposes new longitudinal study will be required validate catalog evidence-based manner.

Язык: Английский

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Natural and Synthetic Cannabinoids: Pharmacology, Uses, Adverse Drug Events, and Drug Interactions

The Journal of Clinical Pharmacology, Год журнала: 2021, Номер 61(S2)

Опубликована: Авг. 1, 2021

The purpose of this narrative review is to describe the current use environment both natural and synthetic cannabinoids while providing context for cannabinoid chemistry pharmacology. In addition a long history recreational nonmedical use, are increasingly used as prescription products, through medical cannabis programs, consumer health products. Despite anecdotal safety evidence, pharmacologically complex pose risks adverse drug events drug-drug interactions. Synthetic cannabinoids, particularly agonists receptors, more potent than can lead severe reactions emergencies. This provides summary approved uses an overview mechanisms action with cannabinoids. Clinical considerations special populations that may be at heightened risk interactions using or examined, recommendations provided.

Язык: Английский

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Factors Associated with Medication Non-Adherence among Patients with Multimorbidity and Polypharmacy Admitted to an Intermediate Care Center

International Journal of Environmental Research and Public Health, Год журнала: 2021, Номер 18(18), С. 9606 - 9606

Опубликована: Сен. 12, 2021

Identifying determinants of medication non-adherence in patients with multimorbidity would provide a step forward developing patient-centered strategies to optimize their care. Medication appropriateness has been proposed play major role non-adherence, reinforcing the importance interdisciplinary review. This study examines factors associated among older and polypharmacy. A cross-sectional non-institutionalized aged ≥65 years ≥2 chronic conditions ≥5 long-term medications admitted an intermediate care center was performed. Ninety-three were included (mean age 83.0 ± 6.1 years). The prevalence based on patients' multiple discretized proportion days covered 79.6% (n = 74). According multivariable analyses, individuals suboptimal self-report adherence (by using Spanish-version Adherence Refills Medications Scale) more likely be non-adherent (OR 8.99, 95% CI 2.80-28.84, p < 0.001). Having ≥3 potentially inappropriate prescribing 3.90, 0.95-15.99, 0.059) barely below level significance. These two seem capture most identified bivariate including burden, experiences related management. Thus, relationship between self-reported provides basis implement targeted improve effective multimorbidity.

Язык: Английский

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Racial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department

American Journal of Geriatric Psychiatry, Год журнала: 2024, Номер unknown

Опубликована: Июль 1, 2024

Язык: Английский

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Preadmission medications and recent falls in older inpatients: an observational study

International Journal of Clinical Pharmacy, Год журнала: 2025, Номер unknown

Опубликована: Фев. 7, 2025

Falls in older adults might increase due to polypharmacy. This study aimed explore the association between preadmission medications and history of falls inpatients. observational inpatients aged ≥ 65 years was conducted over 4 at Ballina Hospital, Australia. The Medication Regimen Complexity Index (MRCI), Drug Burden (DBI), Anticholinergic Effect on Cognition (AEC) scores were calculated for medications. Polypharmacy questionnaires administered identify past 6 months aptitude toward medication use. Overall, 194 participants with a mean age 80.2 (SD 8.0) included. daily number regular 7.8 3.9) MRCI score 22 12.6). Among participants, 107 (55%) reported 47 (24%) 2 falls. Age hearing impairment positively associated (p = 0.007 p 0.003, respectively). History 20 0.018), an AEC 0.010) DBI 1 after adjustment 0.041). Forgetting 0.043). Antihypertensive use did not risk. Implementing decisive approach simplify complex regimens, along patient-focused management strategies, may help reduce risk adults. Sedatives anticholinergic should be avoided whenever possible.

Язык: Английский

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Anticholinergic scales and their relation to polypharmacy, cognition, and functional losses in aged in Brazil

Ciência & Saúde Coletiva, Год журнала: 2025, Номер 30(2)

Опубликована: Янв. 1, 2025

Abstract Aged have a high consumption of medications with anticholinergic activity (MAA), being more vulnerable to adverse events. Using the risk scales, we investigated prevalence and burden MAA in aged, agreement between scales implications using 2 3 on relation polypharmacy, cognition functionality. Cross-sectional study both sexes, aged ≥ 60 years old. The were by scales: drug scale (ADS), (ARS), cognitive (ACB), Brazilian (BSMAA). We analyzed Kappa coefficient logistic regression association with: gender, age, polypharmacy; capacity (MMSE) functional (BOMFAQ questionnaire). Of those interviewed, 1,143 used medication 53.5% MAA. A good was found between: ADS/ACB (0.642), ADS/SBMAA (0.669), ACB/SBMAA (0.656). In multivariate analysis: gender polypharmacy statistically significant.

Язык: Английский

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Impact of drug burden index on adverse health outcomes in Irish community-dwelling older people: a cohort study

BMC Geriatrics, Год журнала: 2019, Номер 19(1)

Опубликована: Апрель 29, 2019

The Drug Burden Index (DBI) quantifies exposure to medications with anticholinergic and/or sedative effects. A consensus list of DBI available in Ireland was recently developed for use as a tool. aim this study validate tool by examining the association score important health outcomes Irish community-dwelling older people.This cohort using data from Longitudinal Study on Ageing (TILDA) linked pharmacy claims data. Individuals aged ≥65 years participating TILDA and enrolled General Medical Services scheme were eligible inclusion. determined applying participants' medication dispensing year prior outcome assessment. recoded into categorical variable [none (0), low (> 0 < 1), high (≥1)]. Outcome measures included any Activities Daily Living (ADL) impairment, Instrumental (IADL) self-reported fall previous 12 months, frailty criterion met (Fried Phenotype measure), quality life (QoL) (CASP-19 [Control Autonomy Self-realisation Pleasure] healthcare utilisation (any hospital admission emergency department (ED) visit) months. Statistical analyses multivariate logistic linear regression models controlling potential confounders.61.3% (n = 1946) participants received at least one prescription before their High (DBI ≥ 1) vs none significantly associated impaired function (ADL impairment adjusted OR 1.89, 95% CI 1.25, 2.88; IADL 2.97, 1.91, 4.61), falls (adjusted 1.50, 95%CI 1.03, 2.18), 1.74, 1.14, 2.67), reduced QoL (β - 1.84, -3.14, 0.54). There no significant between utilisation.The findings predicting risk functional falls, people Ireland, may be extended other European countries. Integration routine practice an appropriate step forward improve people.

Язык: Английский

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Improving medication adherence and effective prescribing through a patient-centered prescription model in patients with multimorbidity

European Journal of Clinical Pharmacology, Год журнала: 2021, Номер 78(1), С. 127 - 137

Опубликована: Авг. 27, 2021

Язык: Английский

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Prevalence and Factors Associated with Potential Drug-Drug Interactions in Older Community-Dwelling Adults: A Prospective Cohort Study

Drugs & Aging, Год журнала: 2021, Номер 38(11), С. 1025 - 1037

Опубликована: Окт. 11, 2021

Older patients are at increased risk of drug-drug interactions (DDIs) due to polypharmacy. Cardiovascular and central nervous system (CNS) drugs commonly implicated in serious DDIs.

Язык: Английский

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