The Association Between Use of Rivastigmine and Pneumonia: Systematic Analysis of FDA Adverse Event Reporting System
| Autor: | Feng Cheng, Gibret Umeukeje, Robert Morris, Kun Bu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Databases Factual medicine.drug_class Cholinergic crisis Rivastigmine Aspiration pneumonia Adverse Event Reporting System Sex Factors Alzheimer Disease Internal medicine Galantamine Adverse Drug Reaction Reporting Systems Humans Medicine Donepezil Adverse effect Nootropic Agents Aged United States Food and Drug Administration business.industry General Neuroscience Pneumonia General Medicine medicine.disease United States respiratory tract diseases Psychiatry and Mental health Clinical Psychology Acetylcholinesterase inhibitor Female Cholinesterase Inhibitors Geriatrics and Gerontology business medicine.drug |
| Zdroj: | Journal of Alzheimer's Disease. 83:1061-1071 |
| ISSN: | 1875-8908 1387-2877 |
| Popis: | Background Pneumonia is an inflammatory condition induced by infection of the lungs and is frequently a cause of morbidity and mortality among patients with Alzheimer's disease (AD). Some studies have shown a correlation between acetylcholinesterase inhibitor use and elevated pneumonia risk. Objective The purpose of this study was to perform a comparative analysis of the number of reported pneumonia cases in individuals prescribed rivastigmine relative to the association between pneumonia risk for other therapeutics including over-the-counter drugs and other AD therapeutics, as reported to the FDA Adverse Event Reporting System (FAERS) database. Methods A disproportionality analysis was conducted to investigate the association between using rivastigmine and risk of pneumonia. Age, gender, dosage, route of administration, temporality, and geographic distribution of reported cases were also assessed. Results Patients prescribed rivastigmine were more likely to report pneumonia as an adverse event than many drugs except galantamine. Males were found to be 46%more likely than females to report pneumonia as an adverse event while likelihood of pneumonia diagnosis increases 3-5-fold in patients older than 65 years of age. Conclusion The observed elevated frequency of aspiration pneumonia in patients prescribed rivastigmine may be due to an induced cholinergic crisis that is selective for the medulla oblongata, resulting in gastrointestinal distress, impaired swallowing, heightened salivation, and labored breathing. The observed elevated frequency of infectious pneumonia in patients prescribed rivastigmine may also be linked to overstimulation of neurons in the medulla oblongata and downstream suppression of localized inflammatory responses. |
| Databáze: | OpenAIRE |
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