PIMsPlus: Medication Reference Site
November, 13, 2020 | 4 Comments
Taper MD today launched PIMsPlus.org, a new free searchable resource for safer medication use which is focused on Potentially Inappropriate Medications (PIMs): medications that should be used with caution in older adults because research and clinical experience with these medications have shown that the risk of adverse effects can outweigh the benefits.
The aim of PIMsPlus.org is to become the best and most easily accessible source for PIM information for patients and healthcare providers.
This project is a partnership between
TaperMD,
The Department of Family Medicine at McMaster University,
The American Society of Consultant Pharmacists (ASCP).
The launch coincides with the ASCP Annual Conference, which started yesterday and runs through the weekend.
You can visit the PIMsPlus site at www.pimsplus.org.
To view the news release and learn more about TaperMD click here.
mary H says:
Well isn't this good news – Rxisk (Data Based America) really is fulfilling its mission of 'making medication safer for us all'. Let's hope that PIMsPlus' medication reference site proves to be as popular with medics and patients as the original 'Rxisk' site is. We wish you all the best of luck. 2020 is turning out to be slightly brighter all of a sudden!
Thank you, and congratulations to all involved.
Really great to see the expertise being expanded and brought together – Ring the Bells
Of further interest: short interview with Dee Mangin at the Dartmouth conference on over diagnosis:
https://www.madinamerica.com/2013/11/taper/
Dee Mangin
@DeeMangin
Leonard Cohen said it: there is a crack in everything – its how the light gets in. Drug side effects are too common causes of death and illness in older adults – this is a great opportunity to improve care. For a #BrighterWorld we need to examine these cracks in the system
https://www.youtube.com/watch?v=6wRYjtvIYK0&feature=emb_logo
The perfect offering …
Putting the horse before the cart – This PIMs project will also probably have the knock on effect of alerting others in elderly peoples' circles of the need to be vigilant Hope it spreads further and wider quickly when the need has an additional need now Covid is rampant ie many , but certainly not all, will be in very vulnerable positions as Vaccines are being prioritised for older people They will be in fairly powerless situations if they decline, Who knows whether proper assessments of the effects of medications will be carried out. I am pretty cynical about the reason they have been prioritised – huge numbers of people will be being trialled without proper safeguards Or has the government and medicos found a conscience or more likely know the cat is out of the bag so the public won't keep quiet any longer about deaths of elderly people.
Should Fluvoxaline be on the PIMs list?
'Filling a Niche'
THURSDAY, Nov. 12, 2020 — The antidepressant drug fluvoxamine — best known by the brand name Luvox — may help prevent serious illness in COVID-19 patients who aren't yet hospitalized, a new study finds.
The study included 152 patients infected with mild-to-moderate COVID-19. Of those, 80 took fluvoxamine and 72 took a placebo for 15 days.
By the end of that time, none of the patients who took the drug had seen their infection progress to serious illness, compared with six (8.3%) of the patients who took the placebo, according to researchers at Washington University School of Medicine in St. Louis.
"The patients who took fluvoxamine did not develop serious breathing difficulties or require hospitalization for problems with lung function," said first author Dr. Eric Lenze, professor of psychiatry.
"Most investigational treatments for COVID-19 have been aimed at the very sickest patients, but it's also important to find therapies that prevent patients from getting sick enough to require supplemental oxygen or to have to go to the hospital. Our study suggests fluvoxamine may help fill that niche," Lenze noted in a university news release.
Fluvoxamine — widely used to treat depression, obsessive-compulsive disorder and social anxiety disorder — is a type of drug called a selective serotonin-reuptake inhibitor (SSRI). This class of drugs also includes medicines such as Prozac, Zoloft and Celexa.
But unlike other SSRIs, fluvoxamine has a strong interaction with a protein called the sigma-1 receptor, which helps regulate the body's inflammatory response.
"There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules," explained study senior author Dr. Angela Reiersen, associate professor of psychiatry.
"Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients," she said in the release.
By reducing inflammation, fluvoxamine may prevent a hyperactive immune response in COVID-19 patients. That, in turn, may decrease their risk of serious illness and death, Reiersen said.
"Our goal is to help patients who are initially well enough to be at home and to prevent them from getting sick enough to be hospitalized," Dr. Caline Mattar, assistant professor of medicine in the Division of Infectious Diseases, said in the release. "What we've seen so far suggests that fluvoxamine may be an important tool in achieving that goal."
The researchers said they plan to begin such a study in the next few weeks and it will include patients from across the United States.
The preliminary study was published online Nov. 12 in the Journal of the American Medical Association.
(What strikes me is although i am not qualified to judge the science ishow shabby some bits of research can be flagged up and published )
KANSAS CITY LAWYERS | DANGEROUS DRUGS
Luvox (fluvoxamine maleate) is an SSRI (selective serotonin reuptake inhibitor). It has been primarily used to treat Obsessive Compulsive Disorder (OCD) and Social Anxiety Disorder (SAD) . It is marketed under the names:
Luvox CR, manufactured by Jazz pharmaceuticals, has recently come under fire from the FDA for it deceptive marketing practices . In 2010, the FDA warned Jazz Pharmaceuticals that a patient brochure for Luvox CR was "false or misleading" because it suggested that Luvox was "safer and more effective than has been demonstrated."
There is a multitude of adverse effects, many induce the sort of symptoms many older people experience anyway
https://www.medicines.org.uk/emc/product/2416/smpc#gref
This is the only para to warn elderly peopleFluvoxamine 100mg Film-Coated Tablets
Wockhardt UK Ltd
Fluvoxamine 100mg Film-Coated Tablets
Adults When is the cut off for people to be classed as elderly
The recommended dose is 100mg daily. Patients should start on 50 or 100mg, given as a single dose in the evening. Dosage should be reviewed and adjusted if necessary within three to four weeks of initiation of therapy and thereafter as judged clinically appropriate. (Are GPs to be trusted to do this? in home visits/in care homes?)
Withdrawal symptoms seen on discontinuation of fluvoxamine:
Abrupt discontinuation should be avoided. When stopping treatment with fluvoxamine the dose should be gradually reduced over a period of at least one or two weeks in order to reduce the risk of withdrawal reactions (see sections 4.4 and 4.8). If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose, but at a more gradual rate.
Depression is associated with an increased risk of suicidal thoughts, self-harm and suicide (suicide-related events). This risk persists until significant remission occurs. As improvement may not occur during the first few weeks or more of treatment, patients should be closely monitored until such improvement occurs. It is general clinical experience that the risk of suicide may increase in the early stages of recovery.
Other psychiatric conditions for which fluvoxamine is prescribed can also be associated with an increased risk of suicide-related events. In addition, these conditions may be co-morbid with major depressive disorder. The same precautions observed when treating patients with major depressive disorder should therefore be observed when treating patients with other psychiatric disorders.
A meta-analysis of placebo-controlled clinical trials of antidepressant drugs in adult patients with psychiatric disorders showed an increased risk of suicidal behaviour with antidepressants compared to placebo in patients less than 25 years old.
Geriatric population:
Data in elderly subjects give no indication of clinically significant differences in normal daily dosages compared to younger subjects. However, upward dose titration should be done slower in the elderly, and dosing should always be done with caution.
Elderly people can obviously suffer from any of the adverse effects – including suicidal thoughts (and When is the objectionable label Geriatric going to be dropped altogether ?- )
And of course on Rxisk
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