A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias

The first line symptomatic treatment for AD is ChEIs. Study on factors that associated with intolerability towards ChEIs in elderly with dementia among Malaysian is still lacking. Study aimed to identify factors associated with intolerability towards ChEIs and to introduce genotyping to identify gen...

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Main Author:	Alias, Rosmaliah
Format:	Thesis
Language:	English
Published:	2017
Subjects:	Neuroscience Biological psychiatry Neuropsychiatry
Online Access:	https://ir.uitm.edu.my/id/eprint/26259/1/TM_ROSMALIAH%20ALIAS%20PH%2017_5.pdf
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spelling	my-uitm-ir.262592019-10-23T08:43:05Z A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias 2017 Alias, Rosmaliah Neuroscience. Biological psychiatry. Neuropsychiatry The first line symptomatic treatment for AD is ChEIs. Study on factors that associated with intolerability towards ChEIs in elderly with dementia among Malaysian is still lacking. Study aimed to identify factors associated with intolerability towards ChEIs and to introduce genotyping to identify genetic factor that may influence intolerability. Factors analysis were based on retrospective record-review and prospective cross-sectional laboratory analysis for genotyping among patients in GMOC, HKL. Patients’ aged 60 years and above with the first exposure with ChEIs were included. Intolerability define as stopping the drug or reducing the dosage because of adverse effects. The intolerability found to be 42.9 %. Sociodemographic factors was not a predictor of intolerability. Drug and SE is the main factors that affecting intolerability. FACED study found patients who were intolerant were at 53 times chance having intolerability at initiation dose regime (OR=53.48, 95 % CI 6.717-425.883, p<0.001), use of concomitant CYP3A4 substrate having 11 times chances of intolerability (OR=11.05, 95 % CI 1.256-97.146, p=0.030) and patient who developed CNS SE were 7 times risk develop intolerability (OR=7.14, 95 % CI 1.672-30.504, p=0.008). For clinical factor, by increasing 1 mmol/L of serum FBG, the chances of intolerability can be reduce by 70 % (OR=0.30, 95 % CI 0.126-0.700, p=0.050). Genotyping identified the most frequent genetic polymorphism were allele 4 (88.8 %), 10 (55.6 %) and *14 (11.1 %). Four intolerants’ are IM but one patient is an EM and does having risk factor as identified earlier and taking CYP2D6 inhibitor agent. This study serve as a new data for our local population. It provide an additional knowledge for pharmacist to play a role in planning for modification of therapy to improve management in dementia patient who requires ChEIs. 2017 Thesis https://ir.uitm.edu.my/id/eprint/26259/ https://ir.uitm.edu.my/id/eprint/26259/1/TM_ROSMALIAH%20ALIAS%20PH%2017_5.pdf text en public masters Universiti Teknologi MARA Faculty of Pharmacy
institution	Universiti Teknologi MARA
collection	UiTM Institutional Repository
language	English
topic	Neuroscience Biological psychiatry Neuropsychiatry
spellingShingle	Neuroscience Biological psychiatry Neuropsychiatry Alias, Rosmaliah A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias
description	The first line symptomatic treatment for AD is ChEIs. Study on factors that associated with intolerability towards ChEIs in elderly with dementia among Malaysian is still lacking. Study aimed to identify factors associated with intolerability towards ChEIs and to introduce genotyping to identify genetic factor that may influence intolerability. Factors analysis were based on retrospective record-review and prospective cross-sectional laboratory analysis for genotyping among patients in GMOC, HKL. Patients’ aged 60 years and above with the first exposure with ChEIs were included. Intolerability define as stopping the drug or reducing the dosage because of adverse effects. The intolerability found to be 42.9 %. Sociodemographic factors was not a predictor of intolerability. Drug and SE is the main factors that affecting intolerability. FACED study found patients who were intolerant were at 53 times chance having intolerability at initiation dose regime (OR=53.48, 95 % CI 6.717-425.883, p<0.001), use of concomitant CYP3A4 substrate having 11 times chances of intolerability (OR=11.05, 95 % CI 1.256-97.146, p=0.030) and patient who developed CNS SE were 7 times risk develop intolerability (OR=7.14, 95 % CI 1.672-30.504, p=0.008). For clinical factor, by increasing 1 mmol/L of serum FBG, the chances of intolerability can be reduce by 70 % (OR=0.30, 95 % CI 0.126-0.700, p=0.050). Genotyping identified the most frequent genetic polymorphism were allele 4 (88.8 %), 10 (55.6 %) and *14 (11.1 %). Four intolerants’ are IM but one patient is an EM and does having risk factor as identified earlier and taking CYP2D6 inhibitor agent. This study serve as a new data for our local population. It provide an additional knowledge for pharmacist to play a role in planning for modification of therapy to improve management in dementia patient who requires ChEIs.
format	Thesis
qualification_level	Master's degree
author	Alias, Rosmaliah
author_facet	Alias, Rosmaliah
author_sort	Alias, Rosmaliah
title	A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias
title_short	A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias
title_full	A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias
title_fullStr	A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias
title_full_unstemmed	A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias
title_sort	study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (the faced study) / rosmaliah alias
granting_institution	Universiti Teknologi MARA
granting_department	Faculty of Pharmacy
publishDate	2017
url	https://ir.uitm.edu.my/id/eprint/26259/1/TM_ROSMALIAH%20ALIAS%20PH%2017_5.pdf
_version_	1783733888927924224

A study of the factors affecting intolerability towards cholinesterase inhibitors in elderly patients with dementia (The Faced Study) / Rosmaliah Alias

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