The Prevalence of Potentially Inappropriate Prescribing in the Elderly at the Primary Care Level in Kazakhstan

BACKGROUND: These potentially inappropriate prescribing is associated with the development of undesired medical reactions in elderly patients, and increase the frequency of hospitalizations, the number of aggravations and the cost of treatment. All of these adverse events are preventable. For detection of PIP and to prevent the adverse drug reactions (ADRs) in elderly patients, it is necessary to screen for potentially inappropriate prescribing. AIM: The aim of the study is to study the prevalence of PIP and the factors associated with these prescriptions at the level primary link in Kazakhstan. METHODS: A prospective descriptive study was carried out at the primary care level, in five clinics in Kazakhstan. The study involved 205 patients over 65 years old who received regular outpatient treatment for chronic diseases. Patients’ current diagnoses and prescription medicines were reviewed and the STOPP and START tools applied. RESULT: The prevalence of PIP in terms of STOPP criteria was 54% (114 patients). In general, we have identified 181 cases of PIP. The most commonly prescribed PIP were moxonidine (20%), glimeperide (16.5%), and PPI (20%). The prevalence of prescribing omissions in terms of START criteria was 22% (48 patients). Overall 66 cases of prescribing omissions were identified. The most commonly prescribed omissions were statins (6%) and ACE inhibitors (4%). Comparative analysis revealed a statistically significant effect of polymorbidity on the prevalence of PIP (p < 0.001) and number of prescribed medicines on the prevalence of PIP (p < 0.05). We have found a statistically significant effect of age on the presence of prescribing omissions of patients. (p < 0.001) CONCLUSION: Our results showed a high prevalence of potentially inappropriate prescribing at the primary care level in Kazakhstan. Screening tools should be incorporated into the everyday practice of primary care doctors.

Experimental study of antiparkinsonian action of the harmine hydrochloride original compound

BACKGROUND

The effects of chemical products on the nervous system have been studied by various scientists. In this work, the antiparkinsonian action of a water-soluble form of harmine hydrochloride was studied. The present studies aim to research antiparkinsonian action of the harmine hydrochloride original compound.

METHODS

To achieve the objective of the study, the authors used haloperidol-induced catalepsy and a method of Parkinson's syndrome (PS) induced by the MPTP (the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) neurotoxin. The experiments were performed on rats and mice which were divided into groups of 10 animals.

RESULTS

It was established that harmine hydrochloride (HH), at a certain dose, eliminated haloperidol-induced catalepsy in rats and reduced oligokinesia and rigidity in the parkinsonism test in mice. Seven days after the experiment, the authors found the presence of rigidity in animals which had received the neurotoxin. It manifested itself in a shortened stride length compared to this parameter in intact controls.

CONCLUSIONS

During the study the efficacy of harmine hydrochloride was equivalent to the effects of levodopa at a certain dose, which suggested that harmine hydrochloride compensated dopamine deficiency in the brain.