Drug administration adjustments for elderly patients with dysphagia: A case report

Mastroianni, Patrícia de Carvalho; Forgerini, Marcela

doi:10.1590/1980-57642018dn12-010015

Cited by 10 publications

(8 citation statements)

References 23 publications

(21 reference statements)

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“…In all 10 patients who started to ingest l -T4 (in a medium dose of 175 µg) while fasting, TSH levels decreased significantly (by 40–96%), while the increase in fT4 levels was observed after 2 months. The results of this study, along with several other [ 33 , 37 ] support the recommendation to postpone food by at least 30–60 min after l -T4 tablet ingestion [ 5 , 6 ].…”

Section: Resultssupporting

confidence: 85%

Levothyroxine Interactions with Food and Dietary Supplements–A Systematic Review

2021

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Levothyroxine (l-thyroxine, l-T4) is a drug of choice for treating congenital and primary hypothyroidism. Although clinically significant interactions between l-T4 and food can alter the safety and efficacy of the treatment, they still seem to be generally underestimated by patients, physicians and pharmacists. This review aimed to investigate the effects of meals, beverages, and dietary supplements consumption on l-T4 pharmacokinetics and pharmacodynamics, to identify the most evident interactions, and to perform the recommendations for safe co-administering of l-T4 and food. A total of 121 studies were identified following a systematic literature search adhering to PRISMA guidelines. After full-text evaluation, 63 studies were included. The results proved that l-T4 ingestion in the morning and at bedtime are equally effective, and also that the co-administration of l-T4 with food depends on the drug formulation. We found limited evidence for l-T4 interactions with coffee, soy products, fiber, calcium or iron supplements, and enteral nutrition but interestingly they all resulted in decreased l-T4 absorption. The altered l-T4 efficacy when ingested with milk, juices, papaya, aluminium-containing preparations, and chromium supplements, as well as observed enhancement effect of vitamin C on l-T4 absorption, shall be further investigated in larger, well-designed studies. Novel formulations are likely to solve the problem of coffee, calcium and iron induced malabsorption of l-T4. Maintaining a proper time interval between l-T4 and food intake, especially for coffee and calcium, or iron supplements, provides another effective method of eliminating such interactions.

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Section: Resultssupporting

confidence: 85%

Levothyroxine Interactions with Food and Dietary Supplements–A Systematic Review

2021

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“…The intervention improved the symptoms of major depression and raised the cognitive impairment score. Consequently, the elderly patient was discharged from the governmental protocol of AD (Mastroianni and Forgerini, 2018).…”

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confidence: 99%

Compliance and drug-related problems in probable Alzheimer’s disease elderly

Mastroianni

Forgerini

2019

Int. Psychogeriatr.

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“…In addition, the pharmacist-led medication therapy management (MTM) can be an effective service after the inclusion of patients on the PCDTDA, because it entails a comprehensive patient assessment considering the underlying disease (AD), confounding factors, prodromal symptoms, and therapeutic experience of the patient and caregiver/family. 12 Previous studies on MTM involving patients diagnosed with AD resolved important problems of effectiveness 13,14 and adherence. 15 Another important aspect in the present study was the non-collection of AD drug therapy (49/260).…”

Section: Discussionmentioning

confidence: 99%

“…These improvements resulted in increased MMSE and CDR scores with consequent discharge of the subject from the PCDTDA. 13 Several factors may be associated with this noncollection. Clearly, free AD drug therapy does not imply access.…”

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confidence: 99%

Monitoring compliance with Clinical Protocol and Therapeutic Guidelines for Alzheimer’s disease

Forgerini

Mastroianni

2020

Dement. neuropsychol.

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Dementia is a chronic neurodegenerative disease and Alzheimer’s disease (AD) is the most prevalent type. Objective: To describe the drug monitoring of patients enrolled in a Clinical Protocol and Therapeutic Guidelines of Alzheimer’s Disease (PCDTDA) in Brazil. Methods: A descriptive study based on interviews conducted in 2017 was performed. Patients diagnosed with Alzheimer’s disease (AD) enrolled on the PCDTDA were included. The variables assessed were age, sex, time since diagnosis, clinical parameters of Mini-Mental State Exam (MMSE) and Clinical Dementia Rating (CDR), drug therapy used and AD drug collection. Results: The drug monitoring of 143 patients was evaluated. Observing the requirements of the screening tests for patient enrolment on the PCDTDA, all patients had scores for at least one MMSE and CDR assessment at protocol admission. None of the patients underwent the first reassessment of the effectiveness of AD drug therapy or the semiannual reassessment. Conclusion: Although PCDTDA provides the best evidence of AD treatment, the data showed failures in the monitoring of the effectiveness of AD drug therapy at dispensing.

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Drug administration adjustments for elderly patients with dysphagia: A case report

Cited by 10 publications

References 23 publications

Levothyroxine Interactions with Food and Dietary Supplements–A Systematic Review

Levothyroxine Interactions with Food and Dietary Supplements–A Systematic Review

Compliance and drug-related problems in probable Alzheimer’s disease elderly

Monitoring compliance with Clinical Protocol and Therapeutic Guidelines for Alzheimer’s disease

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