Abstract:
INTRODUCTION:Potentially inappropriate medication (PIM) prescribing is a global problem. Limited data are available on the prevalence of PIMs in elderly patients with chronic kidney disease (CKD). We examined the PIM prevalence in elderly patients with CKD, the most common drugs implicated and the levels of polypharmacy in this group. METHODS:A retrospective case record analysis of patients with CKD above the age of 70 years was carried out on 100 consecutive inpatients between January 2008 and June 2008 at a University Teaching Hospital. PIMs were defined using the modified Beers' criteria and latest British National Formulary (BNF) guidance for prescribing in patients with renal impairment using creatinine clearance calculated by the Cockroft-Gault formula. RESULTS:The mean age of the cohort was 80 years with a female predominance (62%). The mean estimated glomerular filtration rate (eGFR) was 17.2 ml/min/1.73 m(2). 56 patients had one or more PIMs prescribed during the acute admission period. 81 out of the 622 medications prescribed were 'inappropriate'; therefore, the prevalence of PIMs prescribed was 13%. Antibiotics and antihypertensives accounted for the majority of PIMs. Each patient received an average of six drugs. CONCLUSIONS:The prevalence of PIMs in elderly inpatients with CKD is high. Inclusion of drugs prescribed acutely and use of the BNF to identify PIMs as well as the Beers' criteria may account for this. Use of screening tools may lead to better identification of PIMs in this high risk group. Routine calculation and documentation of eGFR on the medication chart on admission may help reduce PIMs.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Jones SA,Bhandari Sdoi
10.1136/postgradmedj-2012-130889subject
Has Abstractpub_date
2013-05-01 00:00:00pages
247-50issue
1051eissn
0032-5473issn
1469-0756pii
postgradmedj-2012-130889journal_volume
89pub_type
杂志文章abstract::Twenty-six patients with acute leukaemia and other malignancies susceptible to varicella were vaccinated with the Oka-strain live attenuated varicella vaccine during maintenance chemotherapy. All recipients showed no adverse clinical reactions. There was no spread of vaccine virus. Seroconversion was 94% in seronegati...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::A patient is described who developed mild hyponatraemia on two occasions when treated with bendrofluazide alone, but severe hyponatraemia when treated with the combination of enalapril and bendrofluazide. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.746.1105
更新日期:1987-12-01 00:00:00
abstract::The case of a woman with a large benign villous papilloma of the rectum, presenting with sodium and water depletion and later complicated by persistent hypokalaemia, is described. The patient also suffered from primary hypogonadism and diabetes. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.41.474.186
更新日期:1965-04-01 00:00:00
abstract::Testis cancer is an increasing problem, especially in northern European male populations. However, survival has improved dramatically over one generation. Environmental factors may have a role in the aetiology with high oestrogen concentrations implicated. Testis cancer is subdivided between seminoma and non-seminoma....
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2007.057992
更新日期:2007-10-01 00:00:00
abstract::Amniotic fluid embolism (AFE) associated with disseminated intravascular clotting (DIC) is usually fatal. Such a combination generally occurs at the term of pregnancy or in the immediate postpartum period. A case of AFE with DIC following a hypertonic-saline-induced abortion, is reported. The patient was in the midtri...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.688.127
更新日期:1983-02-01 00:00:00
abstract::Stroke is a recognised complication of pregnancy, contributing to more than 12% of all maternal deaths. Estimated incidence rates vary considerably from 4.3 to 210 strokes per 100,000 deliveries. Atherosclerosis is rare in young adults, and so other causes of stroke become increasingly likely. Aetiological factors imp...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2007.066167
更新日期:2008-05-01 00:00:00
abstract::In a retrospective review of patients admitted to a coronary care unit, 809 patients had a definite myocardial infarction and plasma potassium was measured within 48 hr. The mean (+/- s.d.) plasma potassium was 4.04 (+/- 0.56) mmol/litre. A potassium concentration of less than 4.0 mmol/litre was found in 383 patients,...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.692.354
更新日期:1983-06-01 00:00:00
abstract::Erythromelalgia is an unusual condition characterized by attacks of burning pain in the hands and feet with local congestion and increased skin temperature. We report a case of erythromelalgia, with transient hypertension and elevated urinary catecholamines successfully treated by hypnotherapy. Such an association has...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.795.44
更新日期:1992-01-01 00:00:00
abstract:INTRODUCTION:Approximately 366 million people worldwide live with diabetes and this figure is expected to rise. Among the correct diagnosis, there will be errors in the diagnosis, classification and coding, resulting in adverse health and financial implications. AIM:To determine the prevalence and characteristics of d...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
doi:10.1136/postgradmedj-2013-132068
更新日期:2014-01-01 00:00:00
abstract::Asthma is an inflammatory disease characterized by infiltration of the airways by eosinophils and ensuing bronchial hyperresponsiveness. The activation of eosinophils and their recruitment to the airways are strongly influenced by T-lymphocytes and their products. There is now evidence that successful therapy of asthm...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::A host/vector system suitable for large-scale production of HBsAg has been constructed and optimized in terms of the expression plasmid and yeast host strain in order to permit fermentation to very high cell densities. The final expression plasmid contains the coding sequence of the major HBsAg protein (P24) flanked b...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::A case of deliberate overdose of barium sulphide in a psychiatric setting is presented, with resulting flaccid paralysis, malignant arrhythmia, respiratory arrest and severe hypokalaemia, but ultimately with complete recovery. The degree of paralysis appears to be related directly to serum barium levels. The value of ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.74.875.545
更新日期:1998-09-01 00:00:00
abstract::A 46 year old Nigerian man presented with a four week history of progressive bilateral visual loss. He had been unwell, with weight loss, fever, and night sweats for six months. Dilated fundoscopy revealed macular haemorrhages and diffuse Roth's spots. The patient was found to be severely anaemic and a bone marrow asp...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.79.928.108
更新日期:2003-02-01 00:00:00
abstract::A 48 year old white woman was admitted to the hospital because of several bouts of migratory polyarthritis, weight loss, fever, and abdominal pain over a period of 15 months. She had been taking propylthiouracil 100 mg daily for three years for hyperthyroidism treatment. A test for antineutrophil cytoplasmic autoantib...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2004.026104
更新日期:2005-05-01 00:00:00
abstract::A patient with a poorly differentiated clear cell adenocarcinoma of the ovary presenting as pyrexia of unknown origin is reported. Following resection of the tumour, her pyrexia resolved completely. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.712.177
更新日期:1985-02-01 00:00:00
abstract::Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestiv...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.836.365
更新日期:1995-06-01 00:00:00
abstract::Abnormalities in the serum concentrations of calcium, phosphate, parathyroid hormone and vitamin D develop with declining renal function, leading in turn to renal osteodystrophy. Observational data now suggest that these disturbances in bone and mineral metabolism play an important role in the development of vascular ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2008.075515
更新日期:2009-05-01 00:00:00
abstract::Tienilic acid is a diuretic-uricosuric compound whose natriuretic site of action is in the cortical diluting segment of the distal nephron. Oral doses of 250 mg given to normal human volunteers provided peak blood levels of 10--11 micrograms/ml at 3--4 hours after administration. Approximately 40% of the dose was reco...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1979-01-01 00:00:00
abstract::A case of hyperemesis gravidarum at 9 weeks' gestation is described for which no cause could initially be found. Intravenous feeding was needed as a life preserving measure and following improvement on this regime the patient went into a thyrotoxic crisis which was successfully diagnosed and treated. The continuing pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.660.746
更新日期:1980-10-01 00:00:00
abstract::The occurrence of ketoacidosis in out-patient diabetics treated with continuous subcutaneous insulin infusion (CSII) has received little attention. We report two such cases of ketosis, each precipitated by infection and occurring in patients previously well controlled on CSII. This report illustrates that the risk of ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.693.438
更新日期:1983-07-01 00:00:00
abstract::This study assesses the economic benefits of misoprostol in the prophylaxis of gastric ulcers larger than 0.3 cm in patients with osteoarthritis receiving non-steroidal anti-inflammatory drugs. Independent epidemiological data were obtained for patients in Scotland and the West Midlands. Co-diagnosis of arthritis with...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:10.1136/pgmj.66.778.639
更新日期:1990-08-01 00:00:00
abstract::Infection with hepatitis B virus (HBV) is much more common in tropical than in temperate countries. Visitors to the tropics are thus at risk from HBV, though the degree of risk, and the routes of infection involved are uncertain. We report serological markers of HBV in two groups of 2nd World War soldiers, who served ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.783.39
更新日期:1991-01-01 00:00:00
abstract::Chlorpromazine-induced agranulocytosis is an uncommon disorder associated with a high frequency of fatality. We describe two patients with chlorpromazine-induced granulocytosis in whom granulocyte colony stimulating factor (G-CSF) administration enhanced the speed of neutrophil recovery. No toxicity was noted with G-C...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.817.885
更新日期:1993-11-01 00:00:00
abstract::Posterior leukoencephalopathy syndrome is a newly recognised brain disorder that predominantly affects the cerebral white matter. Oedematous lesions particularly involve the posterior parietal and occipital lobes, and may spread to basal ganglia, brain stem, and cerebellum. This rapidly evolving neurological condition...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.77.903.24
更新日期:2001-01-01 00:00:00
abstract::The abnormalities of erythrocytes, leucocytes, thrombocytes and coagulation that have been reported, particularly in more recent years, to be associated with hyperthyroidism are surveyed. Several areas are highlighted where further investigations could lead to clinically useful insights, improved information about the...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.64.756.735
更新日期:1988-10-01 00:00:00
abstract::The use of an emulsion formulation of 2,6-diisopropylphenol (propofol) for induction and maintenance of anaesthesia was compared with methohexitone in 60 patients undergoing termination of pregnancy. In the dosages chosen the two agents appeared to be equi-potent. Propofol was associated with a statistically significa...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:PURPOSE OF THE STUDY:Iron deficiency anaemia (IDA) is associated with increased morbidity and mortality in heart failure patients. The aim of our audit was to evaluate the current practice in diagnosis and assessment of IDA in patients admitted with heart failure. STUDY DESIGN:We conducted a retrospective audit of pat...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2019-136867
更新日期:2020-04-01 00:00:00
abstract::Patient preference for intravenous or subcutaneous heparin in the treatment of deep venous thrombosis was assessed in a randomized cross-over study. Twenty patients with venographically proven deep venous thrombosis were randomized to receive subcutaneous or intravenous heparin for 3 days followed by 3 days of the oth...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.69.808.115
更新日期:1993-02-01 00:00:00
abstract::Motor neurone disease (MND), or amyotrophic lateral sclerosis (ALS), is a neurodegenerative disorder of unknown aetiology. Progressive motor weakness and bulbar dysfunction lead to premature death, usually from respiratory failure. Confirming the diagnosis may initially be difficult until the full clinical features ar...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.78.923.513
更新日期:2002-09-01 00:00:00
abstract::Fibrosing colonopathy is a recently described complication of cystic fibrosis, of unknown aetiology but possibly related to treatment with high-dose pancreatic enzyme supplements. We have used a whole gut perfusion technique to study subclinical gut inflammation in cystic fibrosis patients; concentrations of haemoglob...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00