Drugs online research references








JAMA. 1988 Nov 25;260(20):3016-20.
Psychoactive medication use in intermediate-care facility residents.

Beers M, Avorn J, Soumerai SB, Everitt DE, Sherman DS, Salem S.

Program for the Analysis of Clinical Strategies, Harvard Medical School, Boston, MA 02115.

Despite the large number of elderly patients in nursing homes and the intensity of medication use there, few current data are available on patterns of medication use in this setting. We studied all medication use among 850 residents of 12 representative intermediate-care facilities in Massachusetts. Data on all prescriptions and patterns of actual use were recorded for all patients during one month. On average, residents were prescribed 8.1 medications during the month (interquartile range, 7.4 to 8.8) and actually received 4.7 (range, 4.2 to 5.4) medications during this period. More than half of all residents were receiving a psychoactive medication, with 26% receiving antipsychotic medication. Twenty-eight percent of patients were receiving sedative/hypnotics during the study month, primarily on a scheduled rather than an as-needed basis. Of patients receiving a sedative/hypnotic, 26% (range, 14% to 41%) were taking diphenhydramine hydrochloride, a strongly anticholinergic hypnotic. Of those receiving one of the benzodiazepines, 30% were receiving long-acting drugs, generally not recommended for elderly patients. The typical benzodiazepine dose was equivalent to 7.3 mg per patient per day of diazepam. The most commonly used antidepressant was amitriptyline hydrochloride, the most sedating and anticholinergic antidepressant in common use. These data indicate that despite growing evidence of the risks of psychoactive drug use in elderly patients, the nursing home population studied was exposed to high levels of sedative/hypnotic and antipsychotic drug use. Suboptimal choice of medication within a given class was common, and use of standing vs as-needed orders was often not in keeping with current concepts in geriatric psychopharmacology. Additional research is needed to assess the impact of such drug therapy on cognitive and physical functioning, as well as to determine how best to improve patterns of medication use in this vulnerable population.

KIE: A study of medication use among 850 residents of 12 representative intermediate-care facilities in Massachusetts shows that despite the growing evidence of the risks of psychoactive drug use in elderly patients, this population was exposed to high levels of sedative/hypnotic and antipsychotic drugs. Choice of medication within a given class was often suboptimal, and the use of standing versus as-needed orders was often not in keeping with current concepts in geriatric psychopharmacology. Additional research is needed to determine how best to improve these patterns of medication use.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2903260&dopt=Abstract




Psychopharmacology (Berl). 1985;85(4):460-3.
Purine nucleoside--mediated immobility in mice: reversal by antidepressants.

Kulkarni SK, Mehta AK.

In the forced swimming-induced immobility (despair) test model, adenosine, and 2-chloroadenosine treatment prolonged the immobilization period in mice. Dipyridamole, which is known to inhibit adenosine uptake, potentiated the adenosine effect. The purinoceptor antagonists caffeine and theophylline blocked purine nucleoside-induced enhancement of immobilization. Tricyclic antidepressants such as imipramine and desipramine, the MAO inhibitor tranylcypromine, and amphetamine, a psychostimulant, reversed purine nucleoside-induced immobility. On the other hand, quipazine, fluoxetine, and amitriptyline failed to reverse purine nucleosides-induced prolongation of immobility. None of the antidepressants in the doses investigated had any effect by themselves. Reserpine also prolonged forced swimming-induced immobility in mice. The antidepressants fluoxetine and quipazine, but not methylxanthine pretreatment, reversed reserpine-induced immobility in this test model. These results indicate that adenosine and 2-chloroadenosine probably reduce norepinephrine outflow through their action on presynaptic purinoceptors on noradrenergic neurons and thereby cause prolongation of immobility in animals.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2991960&dopt=Abstract

J Nerv Ment Dis. 1964 Oct;139:370-5.
CONTROLLED COMPARISON OF AMITRIPTYLINE, IMIPRAMINE AND PLACEBO IN HOSPITALIZED DEPRESSED PATIENTS.

HOLLISTER LE, OVERALL JE, JOHNSON M, PENNINGTON V, KATZ G, SHELTON J.

PMID: 14205644 [PubMed - OLDMEDLINE for Pre1966]










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