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Tytuł pozycji:

A Novel Scale Linking Potency and Dosage to Estimate Anticholinergic Exposure in Older Adults: the Muscarinic Acetylcholinergic Receptor ANTagonist Exposure Scale.

Tytuł:
A Novel Scale Linking Potency and Dosage to Estimate Anticholinergic Exposure in Older Adults: the Muscarinic Acetylcholinergic Receptor ANTagonist Exposure Scale.
Autorzy:
Klamer TT; Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.; Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent University, Ghent, Belgium.
Wauters M; Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent University, Ghent, Belgium.
Azermai M; Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent University, Ghent, Belgium.
Durán C; Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent University, Ghent, Belgium.; Ecuadorian Center for Clinical Research, Health Information and Assessment (CIEC), Yachay Public Company, Quito, Ecuador.
Christiaens T; Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent University, Ghent, Belgium.
Elseviers M; Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent University, Ghent, Belgium.; Centre For Research and Innovation in Care (CRIC), University of Antwerp, Wilrijk, Belgium.
Vander Stichele R; Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent University, Ghent, Belgium.
Źródło:
Basic & clinical pharmacology & toxicology [Basic Clin Pharmacol Toxicol] 2017 Jun; Vol. 120 (6), pp. 582-590. Date of Electronic Publication: 2017 Jan 16.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: <2005-> : Oxford : Blackwell
Original Publication: Copenhagen, Denmark : Oxford, UK : Nordic Pharmacological Society Distributed by Blackwell Munksgaard, 2004-
MeSH Terms:
Muscarinic Antagonists/*therapeutic use
Aged ; Cohort Studies ; Drug Utilization ; Humans ; Muscarinic Antagonists/administration & dosage
Substance Nomenclature:
0 (Muscarinic Antagonists)
Entry Date(s):
Date Created: 20170117 Date Completed: 20180307 Latest Revision: 20180307
Update Code:
20220301
DOI:
10.1111/bcpt.12699
PMID:
28090742
Czasopismo naukowe
Quantification of the anticholinergic exposure insufficiently or imprecisely incorporates dosage information, leading to inaccurate estimations. The aim was to construct a novel scale, including potency and dosage for the quantification of the anticholinergic exposure in older adults. Potency information was retrieved from a previous systematic review. The dosage range for each drug was delineated in minimal, maintenance and maximal dosage for adults and older adults. Dosage information was collected from authoritative sources and reviewed in an expert panel. The Muscarinic Acetylcholinergic Receptor ANTagonist Exposure (MARANTE) scale was tested for clinimetric properties using cohorts of community-dwelling older adults and nursing home residents. After three data collection rounds, data for the dosage ranges remained incomplete for 32 active substances. Remaining gaps were filled in, and 11 dosage adjustments were proposed during the expert panel meeting. We chose the values {0; 1; 2) for the categories of potency and {0; 0.5; 1; 1.5; 2) for the levels of dosage ranges, showing good clinimetric properties. Forty-one anticholinergic drugs were prescribed in the two cohorts. Most (61%) were low potency anticholinergics and used for depression (19%, e.g. citalopram). There were 31.8% (median MARANTE 1.5, IQR 1.5-2.5) and 37.6% (median 2, IQR 1.5-2.5) anticholinergic users in the community-dwelling cohort and nursing home cohort, respectively. The MARANTE scale combines potency with the dosage spectrum, to quantify the anticholinergic exposure in older adults. An open feedback system on the list of anticholinergic and proposed anticholinergic potency and dosage values is advised.
(© 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).)

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