PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Polypharmacy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed2000

Polypharmacy in a general surgical unit and consequences of drug withdrawal.

AIMS: To identify drug usage/withdrawal in surgical patients and the relative risk this imposes on postoperative surgical complications. METHODS: A prospective survey of patients' medicines, oral intake (food/fluids/ medicines) and postoperative complications was carried out in the General Surgical Unit, Dunedin Hospital, Dunedin, New Zealand. RESULTS: One thousand and twenty-five general surgical patients aged >/= 16 years, were entered into the study. Half of the patients were taking medicines unrelated to surgery. On average these patients received 9 different drugs (range 1-47) from a selection of 251, of which 21% were released in the last 10 years. The mean number of these drugs taken increased with age, vascular surgery and other major procedures. The majority of patients (53%) were taking drugs for cardiovascular problems. Only 8% of admissions were on the drugs more traditionally recognized to be of importance to the surgery, i.e. steroids and diabetic therapy. With respect to risk, taking a drug unrelated to surgery was associated with an increased relative risk of a postoperative complication by 2.7 (95% C.I. 1.76-4.04) compared with those who were not taking any drug. Cardiovascular drugs contributed significantly to this risk; when they were excluded from analysis, the risk dropped to 1.8 (95% C.I. 1.14-2.93). Death may be more common in those taking ACE inhibitors. Drug withdrawal and complications were analysed and as the time without medicines increased (range 1-42 days) so did the complication rate (chi2 = 14.7, DF = 2, P = 0.007). Of those patients who were taking a cardiovascular medicine and were without their normal medicines for a period of time postoperatively, 12% suffered a cardiac complication. CONCLUSIONS: Many patients admitted to a general surgical ward, are taking medicines unrelated to surgery. Drug therapy unrelated to surgery is a useful predictor for increased postoperative complications and one for which preventive action can be taken. This study provides evidence that withdrawal of regular medicines may add significant risk to the surgery and further complicate outcome. The longer patients were without their regular medicines the more nonsurgical complications they suffered. Reintroduction of patients' regular medicines early in their postoperative course may decrease morbidity and mortality in-patients.

Adolescent↗
PubMed1986

Hypocarnitinemia in the handicapped individuals who receive a polypharmacy of antiepileptic drugs.

Decrease in the serum concentrations of total and free carnitine were found in patients who had received multiple doses of antiepileptic drugs, either including or excluding sodium valproate. These concentrations were more depressed in a former patient group. In all patients there were no abnormal losses of carnitine in urine. Several factors which may be relevant to the hypocarnitinemia were surveyed statistically. The univariate correlation analyses revealed that in all the patients the total and the free carnitine levels were each correlated with the values of arm muscle circumference, and they were inversely correlated with the dosages of sodium valproate. Double regression analyses again revealed that the value of arm muscle circumference is the most critical positive factor, and dosage of sodium valproate is the most critical negative contributor, to both the total and the free serum carnitine concentrations. There was, however, some additional negative contribution by the dosage of phenytoin to the total carnitine concentration. These results indicate that although sodium valproate itself reduces the carnitine concentrations in serum, a poor muscle volume and co-administration of phenytoin with sodium valproate enhance hypocarnitinemia.

Adolescent↗
PubMed1994

Integration of neuropsychological and behavioral neurological assessment in psychiatry: a case example involving brain injury and polypharmacy.

We present a case example that highlights the need for careful neurologic and neuropsychological reevaluations of psychiatric patients who sustain head injuries, and also illustrates the concept that psychopharmacological interventions may impair cognitive performance, especially in a brain-damaged person. As in a previous paper (Weinstein et al. 1991), we emphasize the importance of a multidisciplinary diagnostic and treatment approach that carefully considers psychodynamic, cultural, and neurobiological data. In our experience, a neuropsychological approach is particularly helpful in cases: (1) where brain dysfunction is suspected but focal neurological signs are not identified, and (2) where frank symptoms of medication toxicity are absent but cognitive impairment is greater than expected.

Adult↗
PubMed1995

Beyond performance enhancement: polypharmacy among collegiate users of steroids.

The extremely low prevalence of steroid use among college students makes it virtually impossible to conduct analyses on any single college campus. By studying a cohort of 58,625 college students from 78 institutions that administered the Core Alcohol and Drug Survey in 1990 and 1991, a critical mass of 175 users on which it was possible to conduct statistical analyses was identified. Compared with a randomly selected group of nonusers, the steroid users reported consuming dramatically more alcohol and demonstrated higher rates of binge drinking. In addition, a significantly higher percentage of steroid users reported using tobacco, marijuana, cocaine, amphetamines, sedatives, hallucinogens, opiates, inhalants, and designer drugs. A higher percentage of steroid users than nonusers also reported experiencing negative consequences as a result of substance abuse, and a greater percentage of the steroid users reported family histories of abuse of alcohol and other drugs. Implications from the standpoint of student development are discussed.

Adult↗
PubMed1991

Problems of polypharmacy and intercurrent disease.

Preventing lethal sequelae rather than simply controlling blood pressure is the major goal of antihypertensive treatment. By that criterion, there is reason to question the efficacy of current stepped-care protocols. Alternate approaches that incorporate concerns about both intercurrent disease conditions and their multidrug demands are critically examined.

Antihypertensive Agents↗