20
LA POLIFARMACOTERAPIA: STATO DELL’ARTE FEDERICO PEA ISTITUTO DI FARMACOLOGIA CLINICA PRESIDIO OSPEDALIERO UNIVERSITARIO SM MISERICORDIA ASUI UDINE Udine, 05 Dicembre 2017 GIORNATA REGIONALE DELLA SICUREZZA E QUALITA’ DELLE CURE 2017

LA POLIFARMACOTERAPIA: STATO DELL’ARTE La... · la polifarmacoterapia: stato dell’arte federico pea istituto di farmacologia clinica presidio ospedaliero universitario sm misericordia

  • Upload
    hatruc

  • View
    221

  • Download
    0

Embed Size (px)

Citation preview

LA POLIFARMACOTERAPIA: STATO DELL’ARTE

FEDERICO PEA

ISTITUTO DI FARMACOLOGIA CLINICA

PRESIDIO OSPEDALIERO UNIVERSITARIO SM MISERICORDIA

ASUI UDINE

Udine, 05 Dicembre 2017

GIORNATA REGIONALE DELLA SICUREZZA E QUALITA’ DELLE CURE 2017

Istituto di Farmacologia Clinica - UniUD

Ippocrate (460 - 335 a.C.)

“PRIMUM NON NOCERE”

POLYTHERAPY AND THE RISK OF POTENTIALLY INAPPROPRIATE PRESCRIPTIONS (PIPS) AMONG ELDERLY AND VERY ELDERLY PATIENTS

IN THREE DIFFERENT SETTINGS OF THE FRIULI VENEZIA GIULIA REGION, ITALY Cojutti PG, Arnoldo L, Cattani G, Brusaferro S, Pea F

Pharmacoepidemiol Drug Safety 2016 Sep;25(9):1070-8.

PATIENTS’ CHARACTERISTICS

FACTORS ASSOCIATED AT MULTIVARIATE ANALYSIS WITH POTENTIALLY INAPPROPRIATE PRESCRIPTION (PIP)

POLYTHERAPY AND THE RISK OF POTENTIALLY INAPPROPRIATE PRESCRIPTIONS (PIPS) AMONG ELDERLY AND VERY ELDERLY PATIENTS

IN THREE DIFFERENT SETTINGS OF THE FRIULI VENEZIA GIULIA REGION, ITALY Cojutti PG, Arnoldo L, Cattani G, Brusaferro S, Pea F

Pharmacoepidemiol Drug Safety 2016 Sep;25(9):1070-8.

EXAMPLES OF POTENTIALLY INAPPROPRIATE PRESCRIPTIONS OUTSIDE OF THOSE CONTEMPLATED BY THE BEERS CRITERIA

POLYTHERAPY AND THE RISK OF POTENTIALLY INAPPROPRIATE PRESCRIPTIONS (PIPS) AMONG ELDERLY AND VERY ELDERLY PATIENTS

IN THREE DIFFERENT SETTINGS OF THE FRIULI VENEZIA GIULIA REGION, ITALY Cojutti PG, Arnoldo L, Cattani G, Brusaferro S, Pea F

Pharmacoepidemiol Drug Safety 2016 Sep;25(9):1070-8.

• Controindicazioni:

• Claritromicina

• Gemfibrozil

• Voriconazolo

• Posaconazolo

• Succo di pompelmo

• Non superare 20 mg/die con:

• Amlodipina

• Ranolazine

• Non superare 10 mg/die con:

• Amiodarone

• Verapamil

• Diltiazem

Interazioni farmacologiche

Simvastatina

• Controindicazioni relative:

• Claritromicina

• Gemfibrozil

• Amiodarone

• Verapamil

• Diltiazem

• Amlodipina

• Voriconazolo

• Posaconazolo

• Succo di pompelmo

Atorvastatina

Istituto di Farmacologia Clinica - UniUD

EXAMPLES OF POTENTIALLY INAPPROPRIATE PRESCRIPTIONS OUTSIDE OF THOSE CONTEMPLATED BY THE BEERS CRITERIA

POLYTHERAPY AND THE RISK OF POTENTIALLY INAPPROPRIATE PRESCRIPTIONS (PIPS) AMONG ELDERLY AND VERY ELDERLY PATIENTS

IN THREE DIFFERENT SETTINGS OF THE FRIULI VENEZIA GIULIA REGION, ITALY Cojutti PG, Arnoldo L, Cattani G, Brusaferro S, Pea F

Pharmacoepidemiol Drug Safety 2016 Sep;25(9):1070-8.

Algoritmo per la deprescrizione degli inibitori di pompa protonica (PPI)

Algoritmo per la deprescrizione delle benzodiazepine

Algoritmo per la deprescrizione degli antipsicotici

Algoritmo per la deprescrizione degli ipoglicemizzanti

Algoritmo per la deprescrizione degli inibitori di pompa protonica (PPI)

DISTRIBUTION (%) OF THE 10 DRUGS MOST FREQUENTLY PRESCRIBED IN THE DIFFERENT SETTINGS ACCORDING TO THE ATC CLASSIFICATION

POLYTHERAPY AND THE RISK OF POTENTIALLY INAPPROPRIATE PRESCRIPTIONS (PIPS) AMONG ELDERLY AND VERY ELDERLY PATIENTS

IN THREE DIFFERENT SETTINGS OF THE FRIULI VENEZIA GIULIA REGION, ITALY Cojutti PG, Arnoldo L, Cattani G, Brusaferro S, Pea F

Pharmacoepidemiol Drug Safety 2016 Sep;25(9):1070-8.

Institute of Clinical Pharmacology - UniUD

Institute of Clinical Pharmacology - UniUD

Algoritmo per la deprescrizione degli inibitori di pompa protonica (PPI)

Algoritmo per la deprescrizione delle benzodiazepine

Algoritmo per la deprescrizione degli antipsicotici

Algoritmo per la deprescrizione degli ipoglicemizzanti

Algoritmo per la deprescrizione delle benzodiazepine

DISTRIBUTION (%) OF THE 10 DRUGS MOST FREQUENTLY PRESCRIBED IN THE DIFFERENT SETTINGS ACCORDING TO THE ATC CLASSIFICATION

POLYTHERAPY AND THE RISK OF POTENTIALLY INAPPROPRIATE PRESCRIPTIONS (PIPS) AMONG ELDERLY AND VERY ELDERLY PATIENTS

IN THREE DIFFERENT SETTINGS OF THE FRIULI VENEZIA GIULIA REGION, ITALY Cojutti PG, Arnoldo L, Cattani G, Brusaferro S, Pea F

Pharmacoepidemiol Drug Safety 2016 Sep;25(9):1070-8.

Institute of Clinical Pharmacology - UniUD

Institute of Clinical Pharmacology - UniUD

Institute of Clinical Pharmacology & Toxicology – University Hospital of Udine

William Osler (1849 - 1919)

"One of the first duties of the physician is to educate

the masses not to take medicine"