Brain reference guide by Dale Nibbe

By Dale Nibbe

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Interventions studied included educational interventions, medication reviews, geriatrician services, multidisciplinary teams, computerized support systems, regulatory policies, and multifaceted approaches. Although the evidence base is limited, Kaur and colleagues suggest promising strategies including multidisciplinary case conferences involving a geriatrician, pharmacistled interventions, and computerized support systems (Level 1a evidence) [33]. Another systematic review focused on pharmacist-led interventions has also suggested that pharmacist involvement in the care of hospitalized older adults can have important benefits in reducing inappropriate prescribing (Level 1a evidence) [34].

The practice of geriatrics may change significantly as the result of the transition to EHRs with integrated CDS. It has been theorized that these tools will foster the multidisciplinary management often needed in good geriatric care, linking physicians, nurses, allied health professionals, patients, and family through the EHR, and allowing the center of care for older patients to move from the hospital and clinic to the home [1]. Rapid increases in the size of the geriatric population are expected to occur simultaneously with the rapid expansion of EHRs and CDS, and these two phenomena will doubtlessly interact in some way [1].

Low Chlorpropamide (Diabinese) It has a prolonged half-life in elderly patients and could cause prolonged hypoglycemia. Additionally, it is the only oral hypoglycemic agent that causes SIADH. High GI antispasmodic drugs: dicyclomine (Bentyl), hyoscyamine (Levsin and Levsinex), propantheline (Pro-Banthine), belladonna alkaloids (Donnatal and others), and clidinium-chlordiazepoxide (Librax) GI antispasmodic drugs are highly anticholinergic and have uncertain effectiveness. These drugs should be avoided (especially for long-term use).

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