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Drug Management in the Elderly Adult With Chronic Kidney Disease: A Review for the Primary Care Physician
Mayo Clinic ProceedingsVol. 90Issue 5p633–645Published online: March 12, 2015- Claudio Ponticelli
- Gabriele Sala
- Richard J. Glassock
Cited in Scopus: 30With advancing age, the functional reserve of many organs tends to decrease. In particular, the lean body mass, the levels of serum albumin, the blood flow to the liver, and the glomerular filtration rate are reduced in elderly individuals and can be further impaired by the concomitant presence of acute or chronic kidney disease. Moreover, patients with kidney disease are often affected by comorbid processes and are prescribed multiple medications. The aging process also modifies some drug interactions, including the affinity of some drugs for their receptor, the number of receptors, and the cell responses upon receptor activation. - SUPPLEMENT ARTICLE
Treatment Considerations for Patients With Neuropathic Pain and Other Medical Comorbidities
Mayo Clinic ProceedingsVol. 85Issue 3SupplementS15–S25Published in issue: March, 2010- Maija L. Haanpää
- Geoffrey K. Gourlay
- Joel L. Kent
- Christine Miaskowski
- Srinivasa N. Raja
- Kenneth E. Schmader
- and others
Cited in Scopus: 72The efficacy of drugs for neuropathic pain has been established in randomized controlled trials that have excluded patients with comorbid conditions and those taking complex medications. However, patients with neuropathic pain frequently present with complex histories, making direct application of this evidence problematic. Treatment of neuropathic pain needs to be individualized according to the cause of the pain, concomitant diseases, medications, and other individual factors. Tricyclic antidepressants (TCAs), gabapentinoids, selective noradrenergic reuptake inhibitors, and topical lidocaine are the first-line choices; if needed, combination therapy may be used.
