Preoperative Management of Medications

Zafirova, Zdravka; Vazquez-Narvaez, Karina G; Borunda, Delia

doi:10.1016/j.anclin.2018.07.012

Cited by 5 publications

(9 citation statements)

References 62 publications

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“…Overall, 45% of all patients were affected by polypharmacy. This is in line with other studies investigating elderly patients in peri‐operative context 10,11 . In our cohort, 12% took potentially inappropriate medication according to the PRISCUS list.…”

Section: Discussionsupporting

confidence: 92%

“…Long‐term medication was evaluated with regard to polypharmacy and potentially inappropriate medication. Polypharmacy was defined as greater than or equal to 5 agents 10 , 11 and potentially inappropriate medication was defined according to the PRISCUS 12 and EU(7)‐PIM 13 lists. An initial analysis merely regarded the presence of polypharmacy and the intake of (any) potentially inappropriate medication.…”

Section: Methodsmentioning

confidence: 99%

“…This is in line with other studies investigating elderly patients in peri-operative context. 10,11 In our cohort, 12% took potentially inappropriate medication according to the PRISCUS list. The German PRISCUS list was created with a selective literature search, an analysis of international PIM lists, and a Delphi survey in two rounds (a comprehensive, structured expert survey), and includes 83 drugs.…”

Section: Frequencymentioning

confidence: 99%

“…Although there is no uniform definition for polypharmacy, it is generally described in literature as the long-term intake of greater than or equal to 5 prescription-free and/or prescription drugs. 10,11 To address the increased risk of adverse drug reactions, especially for older people, the German PRISCUS list was published in 2010, 12 which served as basis for the 2015 European list of potentially inappropriate medications (EU(7)-PIM). 13 Drugs from the PRISCUS and EU (7)-PIM lists should be avoided whenever possible in elder patients.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative medication use and development of postoperative delirium and cognitive dysfunction

Heinrich

Nottbrock

Borchers

et al. 2021

Clinical Translational Sci

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Postoperative delirium (POD) and postoperative (neuro‐)cognitive disorder (POCD) are frequent and serious complications after operations. We aim to investigate the association between pre‐operative polypharmacy and potentially inappropriate medications and the development of POD/POCD in elderly patients. This investigation is part of the European BioCog project (http://www.biocog.eu), a prospective multicenter observational study with elderly surgical patients. Patients with a Mini‐Mental State Examination score less than or equal to 23 points were excluded. POD was assessed up to 7 days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method (for the intensive care unit [ICU]), and a patient chart review. POCD was assessed 3 months after surgery with a neuropsychological test battery. Pre‐operative long‐term medication was evaluated in terms of polypharmacy (≥5 agents) and potentially inappropriate medication (defined by the PRISCUS and European list of potentially inappropriate medications [EU(7)‐PIM] lists), and associations with POD and POCD were analyzed using logistic regression analysis. Eight hundred thirty‐seven participants were included for analysis of POD and 562 participants for POCD. Of these, 165 patients (19.7%) fulfilled the criteria of POD and 60 (10.7%) for POCD. After adjusting for confounders, pre‐operative polypharmacy and intake of potentially inappropriate medications could not be shown to be associated with the development of POD nor POCD. We found no associations between pre‐operative polypharmacy and potentially inappropriate medications and development of POD and POCD. Future studies should focus on the evaluation of drug interactions to determine whether patients benefit from a pre‐operative adjustment.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Frequencymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preoperative medication use and development of postoperative delirium and cognitive dysfunction

Heinrich

Nottbrock

Borchers

et al. 2021

Clinical Translational Sci

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“…Die Auswirkung von perioperativen Blutungskomplikationen etwa auf die Mortalität oder die Notwendigkeit von Re-Operationen ist nicht hinlänglich geklärt[34]. In Anbetracht möglicher schwerwiegender Absetzphänomene bei vorübergehender Pausierung oder Dosisreduktion der antidepressiven Pharmakotherapie, v. a. SSRI, und unklarem Nutzen solcher Maßnahmen, wird dieses Vorgehen nicht standardmäßig empfohlen[34]. lativ höchste Risiko (RR 1,62; 95 % KI 1,41-1,85), wobei jedoch keine Betrachtung der einzelnen SSNRI erfolgte und auch unklar bleibt, in welcher Häufigkeit diese jeweils eingenommen wurden.…”

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Das Blutungsrisiko unter Antidepressiva verstehen und einschätzen

Seifert

Eckermann²,

Heck

et al. 2023

Fortschr Neurol Psychiatr

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ZusammenfassungAntidepressiva, insbesondere die selektiven Serotoninwiederaufnahmehemmer (SSRI), sind die meistverordnete psychopharmakologische Arzneistoffgruppe, weshalb eine genaue Kenntnis der zu erwartenden unerwünschten Arzneimittelwirkungen unabdingbar ist. Das erhöhte Risiko für Blutungsereignisse ist vor allem bei Patienten, die mit SSRI behandelt werden, gut belegt. Mit wenigen Ausnahmen können jedoch auch die anderen antidepressiven Arzneistoffgruppen Einfluss auf die Blutgerinnung nehmen und somit das Blutungsrisiko erhöhen. In der nachfolgenden Übersichtsarbeit wird das thrombozytäre Serotoninsystem vorgestellt und die Angriffspunkte der unterschiedlichen Antidepressiva erläutert. Anschließend wird die zur Verfügung stehende Literatur zu Blutungen unter den jeweiligen Antidepressivaklassen bzw. einzelnen Substanzen vorgestellt, wobei hier nach Möglichkeit jeweils Daten aus Meta-Analysen herangezogen werden. Neben dem allgemeinen Blutungsrisiko werden zudem einzelne Blutungsentitäten betrachtet, wie gastrointestinale und Hirnblutungen. Zuletzt werden die Auswirkungen von anderen blutgerinnungsfördernden Arzneistoffen (Nichtsteroidale Antirheumatika, Thrombozytenaggregationshemmer und Antikoagulanzien) in Kombination mit Antidepressiva diskutiert. Mit dem vorgestellten Wissen soll es Behandlern in Zukunft leichter fallen Entscheidungen hinsichtlich einer geeigneten antidepressiven Pharmakotherapie anhand der patientenindividuellen Risikokonstellation zu treffen.

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Perioperatives Management von Polymedikation bei geriatrischen Patienten: Risikoreduktion und Abstimmung mit dem Hausarzt

Abendroth

Klement

2020

Chirurg

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Preoperative Management of Medications

Cited by 5 publications

References 62 publications

Preoperative medication use and development of postoperative delirium and cognitive dysfunction

Preoperative medication use and development of postoperative delirium and cognitive dysfunction

Das Blutungsrisiko unter Antidepressiva verstehen und einschätzen

Perioperatives Management von Polymedikation bei geriatrischen Patienten: Risikoreduktion und Abstimmung mit dem Hausarzt

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