Irregular medication use increases seniors’ chances of falling

Washington, May 20 (ANI): A new study says that older adults increase their chances of falling by not taking their medications as directed.

This new finding comes from a recent study of Boston-area residents over age 70, which found that those who sometimes neglected their medications experienced a 50 percent increased rate of falls compared with those who did not.

“Falls can now be added to the growing list of poor health outcomes associated with non-adherence to medication,” said lead author Sarah D. Berry, a research scientist with the Institute for Aging Research at Hebrew SeniorLife in Boston.

“Because non-adherence is common and easy to screen for, health care providers should discuss this subject with their patients,” she added.

Berry and her co-authors are the first investigators to study the association between falls and medication adherence. The team used data gathered from subjects in the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston (MOBILIZE Boston) Study, a community-based cohort of seniors recruited for the purpose of studying novel risk factors for falls.

They examined responses from a total of 246 men and 408 women with an average age of 78. Between 2005 and 2008, 376 individuals in this group reported a total of 1,052 falls.

A participant was characterized as having low medication adherence if he or she answered yes to any of the following questions: Do you ever forget to take your medications? Are you careless at times about taking your medications? When you feel better do you sometimes stop taking your medications? Sometimes if you feel worse when taking your medication, do you stop taking it? High adherence was defined as a “no” answer to every question. In total, 48 percent of the respondents were classified as having low medication adherence.

Those in the low-adherence group experienced falls at an annual rate of 1.5 times that of the high adherence group. This association persisted after adjusting for other variables, including age, sex, cognitive function, and total number of medications.

The study has been published the latest edition of the Journals of Gerontology Series A: Biological and Medical Sciences. (ANI)

Gene mutation in liver cells to help with drug prescriptions

Washington, May 11 (ANI): A tiny gene mutation in human liver cells might help indicate proper dosage for half of all drugs, suggests a new American study.

The study has been published online in The Pharmacogenomics Journal.

Researchers at Ohio State University and colleagues have identified this mutation, and have shown that it alters the level of a protein in the liver responsible for processing between 45 per cent and 60 per cent of medications used to treat a wide range of conditions.

Each gene contains two alternative forms – called alleles – that are identical in most people.

However, in this case, the researchers found that the activity level, or expression, of one allele differs from its partner allele in a single gene.

That small difference is called a single nucleotide polymorphism, or SNP.

This SNP affects the gene””s protein-producing process, in turn lowering the level of an enzyme known as CYP3A4.

The faster a drug is processed, or metabolized, by this enzyme in the liver, the more quickly it is eliminated from that tissue and the body as a whole.

When this enzyme level is lowered by the presence of this SNP, people are likely to require smaller doses of medicines that the enzyme metabolizes.

But this also means that higher doses of these same drugs can be dangerous to people with the mutation if those levels become toxic.

The study further showed that people with the mutation who take a certain class of cholesterol-lowering drugs do indeed require lower doses of these medications to achieve the same effect that higher doses produce in people without the SNP.

The researchers suggest that this mutation could serve as a molecular biomarker to aid doctors in clinical practice, affecting dosing requirements, patients”” response to medications and toxicity levels of numerous drugs, especially anti-cancer medications.

Lead author Danxin Wang, a research scientist and adjunct assistant professor of pharmacology at Ohio State, said: “With some cancer drugs, there is a very narrow therapeutic index, meaning that if doctors give patients a slightly higher dose, it will cause toxicity. We believe this same biomarker could be used to predict that toxicity threshold in cancer patients.”

Wang noted that using this SNP as a biomarker could reduce the guesswork associated with prescribing drugs.

Wang said: “Right now, because there are no biomarkers available to predict CYP3A4 activity, trial and error determines whether cholesterol goes down with the prescribed dose.

“You never know who has what enzyme level, so you never really know what dose to give an individual if you don””t have a biomarker.” (ANI)

Advance emergency contraception doesn’t reduce pregnancy rates

Washington, Mar 17 (ANI): Women who take emergency contraception in advance of need do not reduce their chances of getting pregnant, despite increased and faster use of such medications after unprotected sexual intercourse, concludes a new study.

Women who take emergency contraception up to five days after unprotected sex are less likely to become pregnant.

However, there are chances that women may not be able to access emergency contraception within this time frame.

In some countries, for instance, emergency contraceptives are not available over the counter and it can be difficult to arrange an appointment with a doctor on public holidays or weekends.

One solution could be that the women should keep a set of emergency contraceptive pills for immediate use, should it be needed.

The review included 11 trials and involved a total of 7,695 women from the US, China, India and Sweden.

The researchers studied the effect of advance provision of emergency contraception on rates of pregnancy and sexually transmitted infections (STIs), as well as on sexual behaviour and contraceptive use.

They found that women with advance access to emergency contraception had similar rates of pregnancy as women who did not receive the medication in advance.

Women given emergency contraception in advance were no more likely to have unprotected sex, to contract STIs, or to change their use of other contraceptive methods.

But, women with advance provision did take the medication an average of 13 hours sooner after sex, and were more likely to use emergency contraception at all.

“Our review suggests that strategies for advance provision of emergency contraception which have been tested to date do not appear to reduce unintended pregnancy at the population level. At the same time, advance provision does not appear to increase the risk of unprotected sex or sexually transmitted infections, and does not change use of other contraceptive methods,” said lead researcher Chelsea Polis of the Johns Hopkins Bloomberg School of Public Health.

“Some women may not use emergency contraception when needed, even if they have it in advance. Like condoms, emergency contraception will not work if it is not used. Women should still be given information about and easy access to emergency contraception, because it is a safe and effective way to prevent unintended pregnancies for individual women who will use it when needed,” added Polis.

The findings have been published in The Cochrane Library. (ANI)

Jackson’s death boosts public concern over prescription drug abuse risk

Washington, July 8 (ANI): The massive media coverage around Michael Jackson’s death has given a boost to public concern over the risks of prescription drug abuse, suggests a survey.

According to the findings of The American Society of Health-System Pharmacists (ASHP), Jackson’s alleged prescription drug misuse has left patients asking more questions about the dangers involved.

“While circumstances surrounding Michael Jackson’s cause of death are still speculative, the media attention has opened dialogue about the dangers of prescription drug abuse,” ASHP president Lynnae M. Mahaney, M.B.A., FASHP said.

“Medications can make a tremendous difference for people suffering with chronic pain and these patients should seek treatment.

“However, these medications are extremely powerful and when used improperly they can cause serious harm, even death,” she added. (ANI)

20 drugs seized from Jacko’s house

London, July 3 (ANI): Cops have reportedly found a horde of 20 different drugs at late singer Michael Jackson’s home, of which ten are potentially lethal painkillers and anaesthetics.

There were anti-anxiety pills, including Valium, Methadone, used to wean junkies off heroin, Demerol, a pain reliever, anaesthetic Propofol, dubbed “the Milk of Amnesia”, Fentanyl, a powerful pain reliever given to terminal cancer patients and Oxycontin, a painkiller similar to morphine but branded “Hillbilly Heroin”.

“The Jackson mansion was more like a drug store than someone’s home,” the Sun quoted a source close to the probe as saying.

Some of the medications bore labels showing that they had been prescribed to Jacko, while rest of them were labelled with other names – and some were not labelled at all.

The King of Pop is believed to have used aliases to obtain his prescriptions.

“Powerful narcotic painkillers of all kinds were found. There was no reasonable excuse for them all being there. Using more than one of this type of drug can be potentially fatal,” said the source.

“But there were ten in the house – it’s unbelievable.

“Police want to know whether the other people named on the medicine labels really needed the drugs prescribed to them and will be speaking to the doctors involved.

“The drugs found remain at the very heart of the investigation into the death of Michael Jackson,” the source added. (ANI)

How Parkinson’s disease can alter a patient’s ability to learn from rewards

Washington, July 1 (ANI): Scientists at Rutgers University, Newark, have developed a new neuropsychological memory test that could uncover how Parkinson’s disease can alter people’s ability to learn about the consequences of the choices they make.

Using the novel feedback-learning task on patients in Hungary, Dr. Mark Gluck at Rutgers’ research team found that non-medicated patients in the early stages of Parkinson’s were selectively impaired at learning from reward.

“What we are seeing in recently diagnosed patients is that prior to being put on any medications, they exhibit a selective impairment in their ability to learn from positive (rewarding) outcomes while their sensitivity to learning from negative (or punishing) outcomes is normal,” said Gluck.

The researchers observed that the reward-learning deficit in un-medicated Parkinson’s patients is quite opposite to that in patients who begin treatment with dopamine agonists-a standard therapy for treating the disease’s motor symptoms.

On dopamine agonists, a patient’s ability to learn from positive rewarding outcomes improved to normal levels, but their ability to learn from negative (or punishing) outcomes, which had previously been normal, was now impaired.

Gluck said that an increased sensitivity to learning from events that results in positive outcomes, coupled with a decrease in the ability to learn from negative outcomes, could explain why some Parkinson patients treated with dopamine agonists develop impulse-control disorders, including pathological gambling, hypersexuality, alcoholism, and compulsive eating and shopping.

Such behaviours can be understood as reward-seeking behaviours in the absence of appropriate sensitivity to their negative consequences.

The ability to test the effects on feedback learning in early onset Parkinson’s disease could provide additional insight into the impact of dopamine loss on cognition and behaviour.

It also could pave the way for identifying which Parkinson’s patients are most likely to experience agonist-related feedback problems so they can be treated with alternate medications.

The findings of the study have been published in the journal Brain. (ANI)

Antidepressants pose risks to cosmetic surgery patients

Washington, Jan 6 (ANI): A research team from New York has found that using common antidepressants and herbal medications may have potentially harmful intraoperative effects on patients undergoing cosmetic surgical procedures.

The researchers conducted and reviewed case studies regarding the effects of the 29 most commonly used herbs and antidepressants, on anesthesia and surgery.

They identified a number of harmful, intraoperative risks, ranging from increased bleeding to fatal interactions.

The researchers have established recommendations for the management of these medications before elective surgery.

They suggest that patients using those antidepressants and herbs noted in the study consult with the prescribing physician about discontinuing use for up to two weeks prior to surgery.

This study appears in the January 2009 issue of Plastic and Reconstructive Surgery. (ANI)

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