Updating the beers criteria for

The elderly population of the United States is projected to grow substantially over the coming decades, comprising 20% of the total population by 2050 [1].The population of those 85 years of age and older (referred to as the oldest-old) is expected to increase from 5.9 million in 2012 to 14.1 million by 2040 [1].[1] The benefits of over-the-counter availability include: [5,6] One area of confusion is the definition of and demarcation between drugs, dietary supplements, and cosmetics.FDA’s definitions of these categories are provided in the following.JAMAJAMA Cardiology JAMA Dermatology JAMA Facial Plastic Surgery JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Des Harnais SIFortham MTHoma-Lowry JMWooster LD Risk-adjusted clinical quality indicators: indices for measuring and monitoring rates of mortality, complications, and readmissions. As practicing physicians, we are charged with caring for our patients with compassion and rigor.The most dangerous drug combinations in the nursing home population involve warfarin interactions with nonsteroidal anti-inflammatory drugs (NSAIDs), sulfonamides, macrolides, or quinolones; angiotensin-converting enzyme (ACE) inhibitor interactions with potassium supplements or spironolactone; digoxin interactions with amiodarone; and theophylline interactions with quinolones.Toxic drug interactions can occur any time two or more medications compete is such a way that their pharmacologic interaction causes a detrimental physiologic response, when a medication is prescribed in excessive amounts, or when one medication produces untoward consequences although it is prescribed according to established guidelines.

The presence of chronic illness is a predictor of greater utilization of healthcare services, including nursing facility residence, and greater number of medications.

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In some cases, there is confusion regarding the proprietary (brand) and generic names of medications, with some patients taking a generic and brand version of the same drug.

The increasing complexity of medication regimens leaves patients vulnerable to the hazards of polypharmacy and adverse drug reactions.

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