Inappropriate Drugs in Elderly Patients with Severe Cognitive Impairment: Results from the Shelter Study
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3463565/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3463565/pdf/pone.0046669.pdf
Lipid-lowering drugs and antiplatelet agents (but not ASA)
followed by
anti-dementia drugs (acetylcholinesterase inhibitors and
memantine ) were the most frequently
inappropriate drugs used,....
Treatments for Depression in Older Persons with Dementia
PMCID: PMC3147175
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147175/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147175/pdf/nihms203041.pdf
PHARMACOLOGICAL TREATMENT OF DEPRESSION IN DEMENTIA
Therefore,
drug interactions and polypharmacy may help provoke BPSD
in some patients with dementia,...
Given their physical and cognitive frailty,
persons with dementia may also be particularly
susceptible to adverse effects.
Since dementia patients may be less able to communicate, clinicians and caretakers must carefully observe patent’s behavior for evidence of adverse events when new medications are introduced.
Prescription of new medications intended to treat depression or other BPSD in dementia patients should always be made using the familiar adage originated for dosing the elderly,
“Start low and go slow”
Memantine
Memantine, ... Glutamate signaling is important for learning and memory,...
A recent review and meta-analysis
of the research on memantine for the treatment of psychological symptoms of dementia showed
small...
In summary, a variety of pharmacological treatments have some efficacy in the treatment of depression in dementia,
but care must be exercised in their use with this population of generally frail older persons to avoid adverse effects.
Efficacy of memantine on behavioral and psychological symptoms related to dementia: a systematic meta-analysis.
http://www.ncbi.nlm.nih.gov/pubmed/18056833
CONCLUSIONS:
However, there are a number of limitations with the current data;
the effect size was relatively small
and whether memantine produces significant clinical benefit is
not clear.
Sunday, February 24, 2013
Saturday, February 23, 2013
Memary (memantine)20mg without BPSD
Without“behavioral and psychological symptoms of dementia”(BPSD), he is found to have got a medication of Memary (memantine) 20mg for Alzheimer's every morning since February.
Sunday, February 17, 2013
Risperidone-Induced Dysphagia?
I read your case report's abstract, Risperidone-Induced Balbar Palsy-like Synd
rome, PMID:20922432.
My family member, 97, has had difficulty swallowing
since the next day after admission to the Kobe Red Cross Hospital(May 18, 201
2)due to cerebellar infarction.He got diapered and strapped to the bed for the
first time. He surely had psychological trauma. The cerebellar infarction res ulted diagnosedly from March 12 falling resulting in facial contusion and internal bleeding. Since then till October 31, he had been given risperidone throu gh three hospitals. I asked the director of the third hospital to stop risperi done due to its side effects. And then, risperidone was completely withdrawn.
According to pharmacists' association, sudden drug withdrawal might result in adverse effect, or retroaction.They recommended dose reduction after long-term medication. Amoban has still been given to him. The doctors here said dysphagia is due chiefly to blood clot and age, and he won't get better. But at the third and fourth hospitals, he takes foods for dysphagia by mouth.
His symptons before admission are as follows:
Aug.2010 one-eye cataract operation, Since then, unable to walk without a sti
ck. neurologically nothing abnormal detected.
Aug. 2011 the other eye cataract operation, still unable to walk without a sti
ck.
Apr.26 2012 instead of a few years long steroid external medication by a town
doctor, resulting in internal bleeding and scrabbling, Yokukansan and Alrock
administered as a drink. after that, feeling sluggish.
May 9 tooth extraction
May 11 enema at the trauma department in hospital due to no effect of 30 year
every third day medication of sennoside by his town doctor
May 14 enema again there because of neglecting another prescription
of every after meal medication of a purgative by the surgeon after that, he fo
llowed the surgeon.
May 15 defecation since that night unable to lift himself and deliria
rome, PMID:20922432.
My family member, 97, has had difficulty swallowing
since the next day after admission to the Kobe Red Cross Hospital(May 18, 201
2)due to cerebellar infarction.He got diapered and strapped to the bed for the
first time. He surely had psychological trauma. The cerebellar infarction res ulted diagnosedly from March 12 falling resulting in facial contusion and internal bleeding. Since then till October 31, he had been given risperidone throu gh three hospitals. I asked the director of the third hospital to stop risperi done due to its side effects. And then, risperidone was completely withdrawn.
According to pharmacists' association, sudden drug withdrawal might result in adverse effect, or retroaction.They recommended dose reduction after long-term medication. Amoban has still been given to him. The doctors here said dysphagia is due chiefly to blood clot and age, and he won't get better. But at the third and fourth hospitals, he takes foods for dysphagia by mouth.
His symptons before admission are as follows:
Aug.2010 one-eye cataract operation, Since then, unable to walk without a sti
ck. neurologically nothing abnormal detected.
Aug. 2011 the other eye cataract operation, still unable to walk without a sti
ck.
Apr.26 2012 instead of a few years long steroid external medication by a town
doctor, resulting in internal bleeding and scrabbling, Yokukansan and Alrock
administered as a drink. after that, feeling sluggish.
May 9 tooth extraction
May 11 enema at the trauma department in hospital due to no effect of 30 year
every third day medication of sennoside by his town doctor
May 14 enema again there because of neglecting another prescription
of every after meal medication of a purgative by the surgeon after that, he fo
llowed the surgeon.
May 15 defecation since that night unable to lift himself and deliria
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