Pill Burden
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Pill Burden
Polypharmacy (polypragmasia) is the simultaneous use of multiple medicines by a patient for their conditions. Most commonly it is defined as regularly taking five or more medicines but definitions vary in where they draw the line for the minimum number of drugs.Taghy N, Cambon L, Cohen JM, Dussart C. Failure to Reach a Consensus in Polypharmacy Definition: An Obstacle to Measuring Risks and Impacts—Results of a Literature Review. ''Ther Clin Risk Manag.'' 2020;16:57-73 https://doi.org/10.2147/TCRM.S214187 Polypharmacy is often the consequence of having multiple long-term conditions, also known as multimorbidity. An excessive number of medications is worrisome, especially for older patients with many chronic health conditions, because this increases the risk of an adverse event in those patients. The prevalence of polypharmacy is estimated to be between 10% and 90% depending on the definition used, the age group studied, and the geographic location. Polypharmacy continues to grow ...
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Datos Pegados Ff93
Datus or Datos ( grc, Δάτος), also Datum or Daton (Δάτον and Δᾶτον), was an ancient Greek city located in Macedonia, specifically in the region between the river Strymon and the river Nestos. It was founded by colonists from Thasos at 360 BCE, with the help and support of the Athenian exiled orator Callistratus of Aphidnae. Datos was a seaport, close to Mount Pangaion with its rich gold veins and to another Thasian colony, Crenides. The two colonies provoked the Thracians but at the same time gave Philip II of Macedon the justification for penetrating the area and founding Philippi in 356 BCE. The name was also applied to a wide region. There was some conjecture that Datus was the same as the later Neapolis (near modern Kavala), A proverb current in antiquity celebrated Datus for its "good things."Zenob. ''Prov. Graec. Cent.'' 3.71; Harpocrat. ''s.v.'' Δάτος See also *Greek colonies in Thrace Greek may refer to: Greece Anything of, from, or rel ...
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Overmedication
Overmedication is an overutilization of medication wherein a patient takes voluntarily, or is prescribed, unnecessary or excessive medications. While not strictly a medical condition, common symptoms may include: slurred speech, drowsiness, confusion, and poor motor skills. Hence it is a risk factor for falls, especially among the elderly. Children with behavior problems are also at risk of overmedication, with parents wanting an easy fix, and drug companies and doctors often obliging. Overmedication in the elderly A report in 2018 by Human Rights Watch, found that every week in American nursing homes, around 180,000 residents are given antipsychotic drugs who do not have the diagnosis for which the drugs are approved. Most of these people have behavioral issues or some form of dementia. The drugs are often administered without informed consent. The reason these drugs are administered is for the sedative effect, which makes the patients docile and easier to manage. Overmedication ...
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Opioid
Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid use disorder, reversing opioid overdose, and suppressing cough. Extremely potent opioids such as carfentanil are approved only for veterinary use. Opioids are also frequently used non-medically for their euphoric effects or to prevent withdrawal. Opioids can cause death and have been used for executions in the United States. Side effects of opioids may include itchiness, sedation, nausea, respiratory depression, constipation, and euphoria. Long-term use can cause tolerance, meaning that increased doses are required to achieve the same effect, and physical dependence, meaning that abruptly discontinuing the drug leads to unpleasant withdrawal symptoms. The euphoria attracts recreational use, and frequent, escalating recreational use of ...
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NMDA Antagonists
NMDA receptor antagonists are a class of drugs that work to antagonize, or inhibit the action of, the ''N''-Methyl-D-aspartate receptor ( NMDAR). They are commonly used as anesthetics for animals and humans; the state of anesthesia they induce is referred to as dissociative anesthesia. Several synthetic opioids function additionally as NMDAR-antagonists, such as pethidine, levorphanol, methadone, dextropropoxyphene, tramadol and ketobemidone. Some NMDA receptor antagonists, such as ketamine, dextromethorphan (DXM), phencyclidine (PCP), methoxetamine (MXE), and nitrous oxide (N2O), are sometimes used as recreational drugs, for their dissociative, hallucinogenic, and euphoriant properties. When used recreationally, they are classified as dissociative drugs. Uses and effects NMDA receptor antagonists induce a state called dissociative anesthesia, marked by catalepsy, amnesia, and analgesia. Ketamine is a favored anesthetic for emergency patients with unknown medical his ...
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Muscle Relaxant
A muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term "muscle relaxant" is used to refer to two major therapeutic groups: neuromuscular blockers and spasmolytics. Neuromuscular blockers act by interfering with transmission at the neuromuscular end plate and have no central nervous system (CNS) activity. They are often used during surgical procedures and in intensive care and emergency medicine to cause temporary paralysis. Spasmolytics, also known as "centrally acting" muscle relaxant, are used to alleviate musculoskeletal pain and spasms and to reduce spasticity in a variety of neurological conditions. While both neuromuscular blockers and spasmolytics are often grouped together as muscle relaxant,
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Antidepressant
Antidepressants are a class of medication used to treat major depressive disorder, anxiety disorders, chronic pain conditions, and to help manage addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, headaches, sexual dysfunction, and emotional blunting. There is a slight increased risk of suicidal thinking and behavior when taken by children, adolescents, and young adults. Discontinuation syndrome may occur after stopping any antidepressant which resembles recurrent depression. Some research regarding the effectiveness of antidepressants for depression in adults has found benefits, whilst other research has not. Evidence of benefit in children and adolescents is unclear. The twenty-one most commonly prescribed antidepressant medications are more effective than placebo for the short-term (acute) treatments of adults with major depressive disorder. There is debate in the medical community about how much of the observed effects of antidep ...
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Antiepileptics
Anticonvulsants (also known as antiepileptic drugs or recently as antiseizure drugs) are a diverse group of pharmacological agents used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder and borderline personality disorder, since many seem to act as mood stabilizers, and for the treatment of neuropathic pain. Anticonvulsants suppress the excessive rapid firing of neurons during seizures. Anticonvulsants also prevent the spread of the seizure within the brain. Conventional antiepileptic drugs may block sodium channels or enhance γ-aminobutyric acid ( GABA) function. Several antiepileptic drugs have multiple or uncertain mechanisms of action. Next to the voltage-gated sodium channels and components of the GABA system, their targets include GABAA receptors, the GAT-1 GABA transporter, and GABA transaminase. Additional targets include voltage-gated calcium channels, SV2A, and α2δ. By blocking sodium or calc ...
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Diabetes Mellitus
Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased appetite. If left untreated, diabetes can cause many health complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, damage to the nerves, damage to the eyes, and cognitive impairment. Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced. Insulin is a hormone which is responsible for helping glucose from food get into cells to be used for energy. There are three main types of diabetes mellitus: * Type 1 diabetes results from failure of the pancreas to produce enough insulin due to lo ...
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Interventionism (medicine)
Interventionism, when discussing the practice of medicine, is generally a derogatory term used by critics of a medical model in which patients are viewed as passive recipients receiving external treatments provided by the physician that have the effect of prolonging life, or at least of providing a subjective sense of doing everything possible. Interventionism is commonly encouraged by terminally ill patients and their family members when they are emotionally unprepared to acknowledge that the patient is going to die. Most healthcare providers are uncomfortable telling people that further cure-oriented or life-extending treatment is futile medical care, and patients and families are frequently angry with the provider or feel rejected by the provider when they are given accurate, but negative, information about the patient's prospects. In nearly all cases, "something" can be done for the patient, and families often reward and encourage a provider who proposes a string of useless and ...
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Information Silo
An information silo, or a group of such silos, is an insular management system in which one information system or subsystem is incapable of reciprocal operation with others that are, or should be, related. Thus information is not adequately shared but rather remains sequestered within each system or subsystem, figuratively trapped within a container like grain is trapped within a silo: there may be much of it, and it may be stacked quite high and freely available within those limits, but it has no effect outside those limits. Such data silos are proving to be an obstacle for businesses wishing to use data mining to make productive use of their data. Information silos occur whenever a data system is incompatible or not integrated with other data systems. This incompatibility may occur in the technical architecture, in the application architecture, or in the data architecture of any data system. However, since it has been shown that established data modeling methods are the root cau ...
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Transitional Care
Transitional care refers to the coordination and continuity of health care during a movement from one healthcare setting to either another or to home, called care transition, between health care practitioners and settings as their condition and care needs change during the course of a chronic or acute illness. Older adults who suffer from a variety of health conditions often need health care services in different settings to meet their many needs. For young people the focus is on moving successfully from child to adult health services. A recent position statement from the American Geriatrics Society defines transitional care as follows: For the purpose of this position statement, transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location. Representative locations include (but are not limited to) hospitals, sub-acute and post-ac ...
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Deprescribing
Deprescribing is the planned and supervised process of intentionally stopping a medication or reducing its dose to improve the person's health or reduce the risk of adverse side effects. Deprescribing is usually done because the drug may be causing harm, may no longer be helping the patient, or may be inappropriate for the individual patient's current situation. Deprescribing can help correct polypharmacy and prescription cascade. Deprescribing is often done with people who have multiple chronic conditions, for older people, and for people who have a limited life expectancy. In all of these situations, certain medications may contribute to an increased risk of adverse events, and people may benefit from a reduction in the amount of medication taken. The goal of deprescribing is to reduce medication burden and harm, while maintaining or improving quality of life. "Simply because a patient has tolerated a therapy for a long duration does not mean that it remains an appropriate tre ...
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