Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Newer generation antidepressant drugs (ADs) are widely used as the first line of treatment for major depressive disorders and are considered to be safer than tricyclic agents. In this critical review, we evaluated the literature on adverse events, tolerability and safety of selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, bupropion, mirtazapine, trazodone, agomelatine, vilazodone, levomilnacipran and vortioxetine. Several side effects are transient and may disappear after a few weeks following treatment initiation, but potentially serious adverse events may persist or ensue later. They encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. At times, such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.
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PMID:The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. 2750 1

The COVID-19 pandemic, being the greatest challenge to our healthcare system for over a century, has its greatest impact on older patients. This subgroup has higher morbidity and mortality than younger age groups. Superimposed on this, the major preventative intervention resulting in social isolation has negative consequences. Prof. Bernard Isaacs described the "Geriatric Giant Symptoms" in 1965 and encouraged the development of interventions for immobility, instability, incontinence and impaired intellect/memory with careful management of these symptoms resulting in better outcomes for older patients including reduced admissions to Nursing Homes and mortality. The author's explore the impact of the current pandemic and, most particularly its aftermath on the provision of such interventions. In the context of a major economic crisis, resources for highly effective interventions such as joint replacement surgery, urological interventions, cataract surgery will be all be limited after this crisis. Moreover delayed access to day patient services with suboptimal access to assessments for conditions such as cognitive decline and falls as well as social care will likewise militate against addressing the "Geriatric Giant Symptoms". Thus the "Founding Fathers" of Geriatric Medicine including Prof Isaacs would be justifiably concerned regarding our ability to deliver interventions to address the "Geriatric Giant Symptoms". Current leaders in geriatric medicine, healthcare workers, funders and providers as well as advocacy groups must redouble their efforts to ensure gains made in management of older patients over 2 generations are not lost in the aftermath of this pandemic.
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PMID:Back to Basics: Giant Challenges to Addressing Isaac's "Geriatric Giants" Post COVID-19 Crisis. 3274 65