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Neoreviews 2001;2:183--191. Enns gm, packman s. Diagnosing inborn errors of metabolism in the newborn. Laboratory investigations. Neoreviews 2001 ;2. 192-200. 790 i inborn errors of metabolism fernandes j, saudubray jm, van de berghe g, et al. Eels. Inborn metabolic diseases. Germany. Springer.

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2002;109(3):S461–s478. 6. Anon, part 1. Executive summary of disease management of drug hypersensitivity. A practice parameter. Ann allergy asthma immunol. 1999;83:665–700. 7. Pichler wj. Delayed drug hypersensitivity reactions. Ann intern med. 2003;139:683–690. 8. Uetrecht j, naisbitt dj. Idiosyncratuc adverse drug reactions. Current concepts. Pharmacol rev.

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Polypharmacy is instant viagra foods prevalent in older adults who compose 14% of the us population but receive 36. 5% of all prescription drugs. 17 an estimated 50% of the communitydwelling elderly take five or more medications, and 12% of them take 10 or more. 19 also, common use of dietary supplements and herbal products in this population adds to polypharmacy. In nursing home settings, patients receiving nine or more chronic medications increased from 17% in 1997 to 27% in 2000. 17 among various reasons for polypharmacy, an apparent one is a patient receiving multiple medications from different providers who treat the patient’s comorbidities without coordinated care. Thus, medication reconciliation becomes increasingly important as the aging population continues to grow. A review analyzing studies aimed at reducing polypharmacy in elderly emphasized complete evaluation of all medications by health care providers at each patient visit to prevent inappropriate polypharmacy. 20 efforts should be made to reduce polypharmacy by discontinuing any medication without indication. However, clinicians should also understand that appropriate polypharmacy is indicated for older adults who have multiple diseases, and support should be provided for optimal adherence. Drug-related problems associated with polypharmacy can be identified by performing a comprehensive medication review (see patient care process). 12  part i  |  basic concepts of pharmacotherapy principles and practices inappropriate prescribing inappropriate prescribing is defined as prescribing medications that cause a significant risk of an adverse event when there is an effective and safer alternative. The incidence of prescribing potentially inappropriate drugs to elderly patients has been reported to be 12% in those living in the community and 40% in nursing home residents. 21,22 a systematic review in 2012 reported that the median rate of inappropriate medication prescribing among elderly patients in the primary care setting was 19. 6%.

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Am j gastroenterol. 2011;106:1188–1192. 14. Witt h, apte mv, keim v, wilson js. Chronic pancreatitis. Challenges and advances in pathogenesis, genetics, diagnosis and therapy. Gastroenterology. 2007;132:1557–1573. 15. Yadav d, whitcomb dc.