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Antipsychotics may be Alzheimer's patients with myocardial infarction

 
 
Reply Mon 16 Apr, 2012 09:11 pm
From Chicago, Illinois, a new study shows that antipsychotic drugs for CASP2 the treatment ofAlzheimer's patients with behavioral symptoms increase in myocardial infarctionincidence, especially in the application of the first month.One retrospective cohort study of 20,000 cases over the age of 64 elderly application ofacetylcholinesterase inhibitor therapy showed that those who start at the same time use of antipsychotic than those who do not use antipsychotics within Casp3 one year have a significantly higher occurrence of heart stems event risk.However, the risk ratio in the first 30 days after starting treatment (relative risk 2.19), thefollow-up evaluation of each point continue to lower.

Despite existing security warning, antipsychotic drugs are still widely prescribed, "theUniversity of CASP4 Montreal, Quebec, Canada the cooperative the researchers YolaMorideDr. said in an interview," With the increasing number of patients with dementia,antipsychotic drug use and increased risk of heart the risk of attack will cause a majorpublic health problem. "The researchers said this is the first time studies have shown that this particular risk in CASP5 the elderly patients will increase. They added that it also stresses the need to strengthenthese risk communication and to closely monitor patients during treatment in the firstweek. " The results showed that 1.3% of the participants began the treatment of CASP6 antipsychoticmyocardial infarction events occurred in 1 year. The risk of myocardial infarction: 30days 2.19,60 days after the start of treatment 1.62,90 days 1.36 and 1 year 1.15.Other antipsychotics led to myocardial infarction are important risk factors: diabetes (p= 0.002), men over 84 years of age (p = 0.006).

The researchers also conducted a self-control series of studies to evaluate only the newusers of antipsychotic patients with myocardial infarction (n = 804) in all nine-year study period (2000-2009, median follow-up time 47 months).The incidence of these patients than for the first 30 days after starting treatment of1.78,31-60 days 1.67,61 90 days 1.37, the remaining exposure time 1.18.Antipsychotic drug use led to an increased risk of myocardial infarction showed amoderate time correlation, "the researchers wrote," look forward to further large samplesurvey to identify high-risk sub-health. "Moride added that the use of antipsychotics to weigh the risks and benefits, should consider these findings. She said, "In addition, the risk is related to time. Therefore, it is important that the previous two months, close follow-up patients."
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Type: Question • Score: 0 • Views: 981 • Replies: 4
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firefly
 
  1  
Reply Tue 17 Apr, 2012 05:03 pm
@yoxi5236,
The incidence of strokes, and death, is also increased when anti-psychotics, particularly atypical anti-psychotics, are prescribed for elderly dementia patients.
Many of these drugs carry a black box warning label regarding use for this group.
Quote:
Despite existing security warning, antipsychotic drugs are still widely prescribed

That's because management issues may over-ride other concerns and risks. It is certainly preferable to find other methods, and try other drugs, before resorting to the use of those with high risk of severely debilitating, and possibly fatal, side-effects. These medications should be used, if at all, as a last resort.

roger
 
  1  
Reply Tue 17 Apr, 2012 05:23 pm
@firefly,
Management issues meaning it's less work to care for the patients? Sounds selfish at first glance. Any chance they are possibly shorting life, but greatly enhancing the quality of life?
firefly
 
  2  
Reply Tue 17 Apr, 2012 09:23 pm
@roger,
Quote:
Any chance they are possibly shorting life, but greatly enhancing the quality of life?

Personally, I don't think so. These neuroleptic drugs don't affect the dementia, at all, they are used in that population mainly to control extreme behavioral agitation. And they can decrease the quality of life, by causing the person to become even more withdrawn or less verbal. And, if the drug contributes to a stroke, that certainly does not enhance the quality of life.

The atypical anti-psychotics seem to carry the most risks, and quite serious risks, for older dementia patients, particularly when they are administered on a continuing regular basis. But there are other, older, anti-psychotic drugs, Haldol, for instance, that can be administered only during a period of acute agitation, that will either calm the person, or knock them out for a short period, without the more dire risks of those other medications.
Quote:
Management issues meaning it's less work to care for the patients?

Management also includes trying to prevent the person from injuring themselves or others--some dementia patients can become quite aggressive--during an episode of agitation.

In facilities for dementia patients, there may be overuse of these medications on a regular basis because that does make life easier for the staff.

Caring for patients in moderate-advanced stages of dementia can be quite a challenging task. Medications to control or contain extreme physical agitation may be necessary at times. But the medications should be used in the lowest doses possible, and only when absolutely necessary, rather than routinely given on a regular basis.
roger
 
  1  
Reply Tue 17 Apr, 2012 09:40 pm
@firefly,
That's pretty clear. Thanks.
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