Polypharmacy:
超過 5 drugs
Appropriate or inappropriate
>65yo = 12% 人口但1/3用藥量
80% 銀髮族每天至少服用一項藥物
加上保健食品?! some of my patients from previous doctor has a total of 10 plus supplements =(
Adverse Drug Effects linked to:
Depression 憂鬱
Constipation 便秘
Falls 跌倒
Immobility 行動不便
Confusion
Hip fracture 盤骨骨折
Other byproducts of the mevalonate pathway (which can also be lowered due to cholesterol reduction) include testosterone, estrogen, and vitamins A, D, and E.
Liver damage, muscle pain, jt main, mm cramping, mental confusion, memory loss, amnesia
hsCRP, Homocystein, ESR
Lp-PLA2 is a marker for vascular-specific inflammation 血管 and also plays a causal role in the vascular inflammatory process, leading to the formation of vulnerable, rupture-prone plaque. Elevated levels have been shown to be powerful predictors of ischemic stroke and heart attack risk.
Gut-brain:
gut-70% nervous system
Probiotic
L-glutamine
Anti-inflammatory: fish oil
Cytokines in blood/inflammatory messengers: CRP, IL-1, IL-6, TNF-alpha: predictive and linearly correlative w/ depression -
NSAIDS: damage brush border cell membraine, disruption of mitochondrial process of oxidative phosphoylation w/ consequent ATP deficiency leaky gut
Pain: curcumin in tumeric, avoid depression
Acetaminophen: tylenol: GSH
Aspirin: folic acid, iron, vit C
NSAID: iron, folic acid
