Making balances between the risks and benefits of pharmacological treatment in dementia, chronic pain and anticoagulation in elderly persons
In dementia, specific drugs and psychotropic drugs used for psychotic and behavioral symptoms have limited efficacy. Adverse effects may be important given the age and comorbidity of the patients. It is necessary, frequently, its withdrawal, planned together with the family, monitoring the response...
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| Veröffentlicht in: | Atención primaria 2018-11, Vol.50 Suppl 2, p.39 |
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| container_title | Atención primaria |
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| creator | Fernández Domínguez, María José Hernández Gómez, Mercedes A Garrido Barral, Araceli González Moneo, María Jesús |
| description | In dementia, specific drugs and psychotropic drugs used for psychotic and behavioral symptoms have limited efficacy. Adverse effects may be important given the age and comorbidity of the patients. It is necessary, frequently, its withdrawal, planned together with the family, monitoring the response and offering non-pharmacological treatment alternatives. Chronic pain is suffered by 25-76% of the elderly who live in a community and is more frequent in women. The treatment is multidisciplinary, establishing realistic objectives, individualizing it, starting with lower doses of drugs and continuously reevaluating to control side effects and to get the correct level of analgesia. The prevalence of atrial fibrillation increases with age and is underdiagnosed. ACO is recommended with dicoumarin or direct oral anticoagulants not antagonists of vitamin K, in patients with AF older than 65 years unless contraindicated, to reduce embolic risk, confirming subgroup analyzes similar efficacy in prevention of stroke. |
| doi_str_mv | 10.1016/j.aprim.2018.09.003 |
| format | Article |
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Adverse effects may be important given the age and comorbidity of the patients. It is necessary, frequently, its withdrawal, planned together with the family, monitoring the response and offering non-pharmacological treatment alternatives. Chronic pain is suffered by 25-76% of the elderly who live in a community and is more frequent in women. The treatment is multidisciplinary, establishing realistic objectives, individualizing it, starting with lower doses of drugs and continuously reevaluating to control side effects and to get the correct level of analgesia. The prevalence of atrial fibrillation increases with age and is underdiagnosed. ACO is recommended with dicoumarin or direct oral anticoagulants not antagonists of vitamin K, in patients with AF older than 65 years unless contraindicated, to reduce embolic risk, confirming subgroup analyzes similar efficacy in prevention of stroke.</description><identifier>ISSN: 1578-1275</identifier><identifier>EISSN: 1578-1275</identifier><identifier>DOI: 10.1016/j.aprim.2018.09.003</identifier><identifier>PMID: 30563624</identifier><language>spa</language><publisher>Spain</publisher><subject>Aged ; Analgesics - therapeutic use ; Anticoagulants - adverse effects ; Anticoagulants - therapeutic use ; Antidepressive Agents - therapeutic use ; Atrial Fibrillation - complications ; Cholinesterase Inhibitors - adverse effects ; Cholinesterase Inhibitors - therapeutic use ; Chronic Pain - drug therapy ; Contraindications, Drug ; Dementia - complications ; Dementia - drug therapy ; Deprescriptions ; Embolism - etiology ; Embolism - prevention & control ; Female ; Humans ; Male ; Medical Overuse - prevention & control ; Nootropic Agents - adverse effects ; Nootropic Agents - therapeutic use ; Risk Assessment ; Sex Factors ; Sleep Initiation and Maintenance Disorders - drug therapy</subject><ispartof>Atención primaria, 2018-11, Vol.50 Suppl 2, p.39</ispartof><rights>Copyright © 2018 The Authors. 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Adverse effects may be important given the age and comorbidity of the patients. It is necessary, frequently, its withdrawal, planned together with the family, monitoring the response and offering non-pharmacological treatment alternatives. Chronic pain is suffered by 25-76% of the elderly who live in a community and is more frequent in women. The treatment is multidisciplinary, establishing realistic objectives, individualizing it, starting with lower doses of drugs and continuously reevaluating to control side effects and to get the correct level of analgesia. The prevalence of atrial fibrillation increases with age and is underdiagnosed. ACO is recommended with dicoumarin or direct oral anticoagulants not antagonists of vitamin K, in patients with AF older than 65 years unless contraindicated, to reduce embolic risk, confirming subgroup analyzes similar efficacy in prevention of stroke.</description><subject>Aged</subject><subject>Analgesics - therapeutic use</subject><subject>Anticoagulants - adverse effects</subject><subject>Anticoagulants - therapeutic use</subject><subject>Antidepressive Agents - therapeutic use</subject><subject>Atrial Fibrillation - complications</subject><subject>Cholinesterase Inhibitors - adverse effects</subject><subject>Cholinesterase Inhibitors - therapeutic use</subject><subject>Chronic Pain - drug therapy</subject><subject>Contraindications, Drug</subject><subject>Dementia - complications</subject><subject>Dementia - drug therapy</subject><subject>Deprescriptions</subject><subject>Embolism - etiology</subject><subject>Embolism - prevention & control</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical Overuse - prevention & control</subject><subject>Nootropic Agents - adverse effects</subject><subject>Nootropic Agents - therapeutic use</subject><subject>Risk Assessment</subject><subject>Sex Factors</subject><subject>Sleep Initiation and Maintenance Disorders - drug therapy</subject><issn>1578-1275</issn><issn>1578-1275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkM1KAzEUhYMotlafQJAsXdgxP01mZiniHyhudF1u0jtt2plkTFLEd_ChnWIFV_fw8XHgHkLOOSs44_p6XUAfXVcIxquC1QVj8oCMuSqrKRelOvyXR-QkpTVjQtSyPCYjyZSWWszG5PsFNs4vqYEWvMVEDeZPRE_zCml0aZMo-MVAPTYuJxoa2q8gdmBDG5bOQktzRMgd-kydpwvcJQdX1K5i8M7SHga864CB2wDLbQvZBb-zsV1gbL9ojzEFn07JUQNtwrP9nZD3-7u328fp8-vD0-3N87QXnOepnRnNLFplZtJaUVvGoa6HP0FXlmsEXnFTolF8UKASjWlKyWVlaq2VlEZOyOVvbx_DxxZTnncuWWyHCTBs01xwVSktypka1Iu9ujUdLua7xSF-zf8WlD-rx3dk</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Fernández Domínguez, María José</creator><creator>Hernández Gómez, Mercedes A</creator><creator>Garrido Barral, Araceli</creator><creator>González Moneo, María Jesús</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201811</creationdate><title>Making balances between the risks and benefits of pharmacological treatment in dementia, chronic pain and anticoagulation in elderly persons</title><author>Fernández Domínguez, María José ; 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| ispartof | Atención primaria, 2018-11, Vol.50 Suppl 2, p.39 |
| issn | 1578-1275 1578-1275 |
| language | spa |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Analgesics - therapeutic use Anticoagulants - adverse effects Anticoagulants - therapeutic use Antidepressive Agents - therapeutic use Atrial Fibrillation - complications Cholinesterase Inhibitors - adverse effects Cholinesterase Inhibitors - therapeutic use Chronic Pain - drug therapy Contraindications, Drug Dementia - complications Dementia - drug therapy Deprescriptions Embolism - etiology Embolism - prevention & control Female Humans Male Medical Overuse - prevention & control Nootropic Agents - adverse effects Nootropic Agents - therapeutic use Risk Assessment Sex Factors Sleep Initiation and Maintenance Disorders - drug therapy |
| title | Making balances between the risks and benefits of pharmacological treatment in dementia, chronic pain and anticoagulation in elderly persons |
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