Potentially inappropriate medication use in institutionalized older adults according to the Beers Criteria

The need for specific care, coupled with new family arrangements, has contributed to the increasing institutionalization of elderly members. The purpose of this study was to evaluate drug use by institutionalized older adults according to Beers Criteria. This prospective, longitudinal study was conducted in the three non-profit long-stay geriatric care institutions of Campo Grande, in the Central-West region of Brazil. All subjects aged 60 years and above on November 2011 were included and followed until November 2012. Eighteen subjects were excluded and the final sample consisted of 133 individuals aged 60 to 113 years. Overall, 212 medications were used at geriatric care institution A, 532 at B, and 1329 at C. Thirty-four drugs were inappropriately prescribed 89 times at geriatric care institution A (41.98%), 49 prescribed 177 times at B (33.27%), and 91 prescribed 461 times at C (34.68%). Statistical differences in the inappropriate drug use were found between genders (p=0.007). The most commonly used potentially inappropriate medication were first-generation antihistamines (15.34%). There was a high frequency in the use of potentially inappropriate medications which can initiate marked side effects and may compromise the fragile health of institutionalized elderly. Thus, adopting the Beers Criteria in prescribing medication contributes to minimize adverse reactions and drug interactions

Fourteen New Species And Two Taxonomic Notes On Brazilian Myrtaceae

Fourteen new Myrtaceae are described, illustrated and compared to related species from Brazil: Calyptranthes boanova, C. curta, C. detecta, C. maritima, Eugenia culta, E. rotula, E. serraegrandis, E. unana, Myrcia clavata, M. lascada, M. teimosa, M. truncata, Myrcianthes riparia and Myrciaria alagoana. Calyptranthes boanova is related to C. grandiflora, but presents sessile, glabrous leaves; C. curta is related to C. dichotoma, differing through the small inflorescences; C. detecta is close to C. tricona, but has largest leaves and inflorescences; C. maritima is related to C. strigipes, but presents larger leaves and inflorescences and smaller flowers; Eugenia culta is related to E. sprengelii, but presents verticillate leaves and longer pedicels; E. rotula is distinct from all Brazilian species by its small rounded leaves; E. serraegrandis is related to E. platyphylla, differing in its larger leaves and densely pilose flowers; E. unana is close to E. stictopetala, but the leaves are wider and more laxly venose and the flowers present larger calyx lobes; Myrcia clavata is close to M. riodocensis, but has wider leaves and pentamerous flowers; M. lascada is related to M. palustris, from which it differs by the larger leaves and three to five-flowered inflorescences; M. teimosa is related to M. eximia, differing through shorter inflorescences and four-celled ovaries; M. truncata is distinguished from all Brazilian species through its basally truncate leaves; Myrcianthes riparia is close to M. pedersenii, but has glabrous leaves and flowers, tetramerous flowers and smaller, purple fruits, and Myrciaria alagoana is related to M. glomerata, but has larger petioles and glabrous and caudate leaves. Calyptranthes boanova, Eugenia serraegrandis, E. unana, Myrcia lascada, M. teimosa and M. truncata were collected in the southern Bahian rainforests; Calyptranthes curta and C. maritima are from the coastal rainforests of the southeastern state of São Paulo; C. detecta is from the rainforests of southeastern Minas Gerais; Eugenia culta was collected along the Atlantic Rainforest (Mata Atlântica) domain in the southeastern Brazilian states of Espírito Santo and Minas Gerais; Eugenia rotula was collected in rocky fields from the Bahian hinterland; Myrcia clavata and Myrciaria alagoana are from the Atlantic Rainforest of the northeastern state of Alagoas, and Myrcianthes riparia grows in riverine habitats in the highlands of the southern Brazilian states of Rio Grande do Sul and Santa Catarina. 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