Antibiotic-associated acute kidney injury (AA-AKI) is quite common, especially among hospitalized patients; however, little is known about risk factors or mechanisms of why AA-AKI occurs. In this review, the authors have reviewed all available literature prior to June 1, 2022, with a large number of AKI reports. Information regarding risk factors of AA-AKI, mechanisms behind AA-AKI, and treatment/management principles to decrease AA-AKI risk were collected and reviewed. Patients treated in the inpatient setting are at increased risk of AA-AKI due to common risk factors: hypovolemia, concomitant use of other nephrotoxic medications, and exacerbation of comorbid conditions. Clinicians should attempt to correct risk factors for AA-AKI, choose antibiotic therapies with decreased association of AA-AKI to protect their high-risk patients, and narrow, when clinically possible, the use of antibiotics which have decreased incidence of AKI. To treat AKI, it is still recommended to discontinue all offending nephrotoxic agents and to renally adjust all medications according to package insert recommendations to decrease patient harm.
Objective. To assess whether the Jellybean Polypharmacy Simulation Exercise (JPSE) improved empathy in pharmacy students. Methods. The JPSE was given to all third-professional year pharmacy students in a required Special Populations course with pre-and post-scores on the Kiersma-Chen Empathy Scale (KCES) assessed, and open-ended questions on lessons learned from the exercise. Results. Pharmacy students showed a statistically significant increase in KCES scores after completing the JPSE. Open-ended question responses reflected personal growth and appreciation for patients managing difficult medication regimens. Conclusion. This polypharmacy simulation showed the ability to increase empathy in pharmacy students, as well as mimic a realistic experience in managing a multi-drug, multi-dose medication regimen.Keywords: polypharmacy, simulation, empathy INTRODUCTIONThe ability to empathize is an essential element of the health care provider-patient relationship, yet is difficult to assess formally. [1][2][3] Empathy is a core element of improving patient outcomes and has been shown to decrease the potential for litigation in the medical literature. [4][5][6][7][8] Empathy is enhanced through experiences in which an individual has the opportunity to view a situation from the perspective of another. The demographics of the pharmacy student body evaluated was different in average age and in overall health status as compared to those of the patient population represented by this exercise. It is this difference in life experience that offers an opportunity for a simulated activity to have value for inculcating empathy. With the aging of America, and the dependence of our nation's seniors on complex medication regimens for the care of chronic conditions, it is imperative for health professionals not only to understand what polypharmacy is, but how it feels. 9Given the potential impact of age and health discordance between the pharmacy learner and patient, the use of a simulated polypharmacy exercise could be an important tool for increasing the learner's empathy for those managing complex medication regimens. The Jellybean Polypharmacy Simulation Exercise (JPSE) was developed as a way to inculcate empathy for those managing multi-drug, multi-dose regimens on a daily basis. The JPSE is an eight-"prescription" regimen students manage for 7 consecutive days. This regimen includes varied dosing schedules, a drug-drug interaction that needs to be mitigated by a 2-hour separation, and meal-time dosing considerations.While multi-drug simulation exercises are not new to pharmacy education, research has focused on the ability of students to adhere to a complex regimen.10-13 Researchers have also attempted to assess the impact of interventions on empathy within simulation education; however, there is no research to date on the impact of a polypharmacy simulation on empathy using a validated empathy scale.14 The objective of this study was to determine the effectiveness of the JPSE to inculcate student METHODSAll third-year pharmacy...
Introduction Neuropsychiatric disorders affect millions of older adults. Despite this, there are relatively few older adults included in clinical trials evaluating treatments for psychiatric disorders. Citalopram has been evaluated in older adults with neuropsychiatric disorders and has largely been found beneficial, making the 2011 US Food and Drug Administration (FDA) safety advisory on citalopram extremely impactful. Methods A literature search was completed using the PubMed database. Results were limited to clinical trials conducted in older adults that were published in English. Results Review of the literature confirms the efficacy of citalopram in depression, anxiety, depression associated with Parkinson disease, and behavioral and psychological symptoms of dementia. Additionally, no adverse cardiac outcomes have been described related to citalopram. Discussion The FDA's evidence for applying this safety advisory to citalopram is minimal and largely based on surrogate markers, such as the QTc interval rather than clinical and safety outcomes. Citalopram is known to increase the QTc, but this increase has not been linked to adverse cardiac outcomes. The evidence for efficacy and against adverse outcomes suggests that a reevaluation of the dosing restrictions in older adults with neuropsychiatric disorders is needed.
PACE participants were prescribed fewer medications and had lower anticholinergic burden, which potentially lowers their risk of adverse effects. These data support the PACE interdisciplinary model by demonstrating the benefit of team care in appropriate use of medications. It provides a potential blueprint to organizations aimed at reducing potentially inappropriate medication prescribing in older adults.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.