Search for Oral Medicine That Might Exacerbate the Prognosis of Adverse Drug Events in Elderly Patients / 医薬品情報学

<b>Objective: </b>Elderly patients commonly experience adverse drug events (ADEs) owing to their poor drug metabolizing and excretion ability, and these often cause multiple organ dysfunction syndrome.  Therefore, it is important that we identify the adverse drug events early on during prognosis.  We searched for oral medicines that might exacerbate the prognosis of ADEs in elderly patients.<br><b>Methods: </b>The objects under analysis were oral medicines that were registered in the Japanese Adverse Drug Event Report database (JADER).  The associations between the elderly/non-elderly patients and exacerbation risk/non-exacerbation risk were analyzed by risk ratios (RR).  The signal detection of exacerbation risk was defined as 95% confidence interval of lower limit of risk ratio>1 and χ²≥4.<br><b>Results: </b>The oral medicines that might markedly exacerbate the prognosis of ADEs in the elderly patients in comparison with the ADEs of young patients included 84 items, of which 63 have not been described as potentially inappropriate medicines in all guidelines for medical treatment of the elderly patients.<br><b>Conclusion: </b>In this study, while we could not search for oral medicines having a high risk of ADEs, we were able to search for oral medicines that might exacerbate the prognosis of ADEs in elderly patients.  This result could contribute to the proper use of medicines in the elderly patients.

Examination for Safety of Antiplatelet Therapy in the Elderly Patients Using Data Mining of the Japanese Adverse Drug Event Report (JADER) Database / 医薬品情報学

<b>Objective: </b>Antiplatelet therapy is useful for infraction prevention.  But, in elderly patients, adverse events are easily observed, owing to the decrease in metabolism and excretion of drugs.  Furthermore, applying guidelines for medical care of each disease does not necessarily result in good conclusions.  Therefore, we used Japanese Adverse Drug Event Report database and assessed safety signals with signal detection about adverse events developed by the antiplatelet therapy in the elderly patients.<br><b>Methods: </b>We analyzed all adverse events reported on ticlopidine hydrochloride that should be carefully administered, and clopidogrel, bisulfate and aspirin that are recommended as the alternative drugs.  We used the proportional reporting ratio for a safety index of drugs.<br><b>Results: </b>While some adverse events were expressed in only ticlopidine hydrochloride, bleeding signal was detected in all the subject agents.  In addition, onset risk of ticlopidine hydrochloride was found to be the lowest value.  Moreover, adverse events expressed in clopidogrel bisulfate and aspirin were of a wide-variety compared with ticlopidine hydrochloride.<br><b>Conclusion: </b>It is necessary to carefully administer not only ticlopidine hydrochloride but also the alternative drugs to the elderly patients as indicated, and there is a need to pay careful attention to administration of the alternative drugs.

Observation on 120 cases of pulmonary infection of the aged people treated with the combination of traditional Chinese medicine and western medicine / 国际中医中药杂志

Objective To observe the effects of treating pulmonary infection of the aged people with the combination of TCM and WM.Methods A total of 120 the aged patients with pulmonary infection were randomly recruited into a control group and a treatment group,60 patients in each.The control group was treated with cefoperazone,sulbactam intravenously drop and inhalation of low flow oxygen(1～2L/min,2～4h,once/day),while the treatment group was added modified Xiaocaihu decoction and Shengmai injection on the basis of the control group.Both groups were treated for 14 days.Results The significant effective rate was 63.3%and 45.0%in the treatment group and the control group respectively,showing significant difference(U=0.5248,P<0.01).The effective rate was 96.7%and 83.3%in the treatment group and the control group respectively,also showing significant difference(U=0.5314,P<0.05).Conclusion It is effective to treat pulmonary infection of the aged patients with modified Xiaocaihu decoction and Shengmai decoction together with western medicine.

Propofol anesthesia with target-controlled influsion technic modulated by cerebral state index in the elderly patients with tumor / 重庆医科大学学报

Objective:To study the clinical benefit of propofol anesthesia with target-controlled influsion technic modulated by cerebral state index in the elderly patients with tumor. Methods:A total of 126 ASA Ⅰ or Ⅱ aged65 yrs or older patients underwent gastrectomy and rectal surgery were randomly divided into tow groups(n=63 each):group by target-controlled influsion technic modulated(groupⅠ)and group by target-controlled influsion(groupⅡ). CSI of groupⅠwas 50. Propofol of two groups was administered by TCI at a target blood concertration of 2?g/ml during induction of anesthesia and maintenance of anesthesia,sufentanil of two groups was administered by TCI at a target blood concertration of 1.5?g/ml during induction of anesthesia and of 0.3ng/ml during maintenance of anesthesia. MAP,HR,HRV and CSI of the foundation(T1),intubation(T2),five minutes after intubation(T3),chip(T4),the tumor excision(T5) and the end of surgery(T6) were recorded. And the total of propofol was recorded. Results:MAP at T3,T4 and T5 of groupⅡdecreased obviously compared to that of groupⅠ(P