Chapters authored
Inappropriate Medication and Perception of Quality of Life in Hospitalized Elderly Patients
Older or elderly adults represent a population exposed to potentially inappropriate prescriptions, since medication is the most widely used intervention. The objective of this work is to analyze the type of medication schemes of the elderly and the relationship with their states of psychological well-being. It is a cross-sectional study. Results: inappropriate prescription is of the order of 16% and the perception of quality of life was 56.8, finding an association between inappropriate prescription and perception of quality of life. Conclusions: The results showed that inappropriate prescription is highly frequent in these patients and that psychological well-being states would be related to this inappropriate prescription.
Part of the book: Update in Geriatrics
Analysis of the Behavior of Plasma Concentrations of Tacrolimus in Adult Patients with Liver Transplantation: Adverse Reactions and Drug Interactions and Their Relevance to Patient Safety
Organ transplantation is a medical treatment often used to restore the function of vital organs. Tacrolimus is one of the most widely used drugs in the immunosuppressive treatment of liver transplants. Aims: To analyze plasma concentrations of tacrolimus in adult liver transplant patients and to characterize adverse effects and drug interactions. Design: retrospective observational studies. The study included 32 patients, of whom 22 were male and 10 female. The average values and range of tacrolimus obtained showed a mean of 8.7 SD 3.2. Low values were found in seventy-five cases, with a percentage of 54.8%. The values within the expected had a frequency of fifty-three times with a percentage of 38.7%. Finally, the frequency of high values was nine times with a percentage of 6.5%. A total of 36 RAM types were found. It was determined that the majority of the ADRs were of moderate damage (13) of 46.4%, while 39.3% of the ADRs were of slight damage (11), 14.3% were of severe damage (4) and no ADR was incidental. Clinically relevant drug interactions in this group of patients were 16.7% contraindicated, 16.7% adjustments based on close follow-up, and 66.6% use with routine follow-up. Similar to the interactions present in the 2013 EMA data sheet. Plasma tacrolimus concentrations are within the range of 38.7% in male patients and 40.8% in female patients. 61.3% of male patients and 59.2% of female patients do not reach the expected tacrolimus plasma levels of 8.0−11.0 ng/ml, similar to those presented in the 2009 FDA data sheet. There were 220 ADRs in this sample of 32 liver transplant patients.
Part of the book: Controversies in Liver Transplantation