22nd Annual Geriatrics Update Examines Key Topics: Herbal Supplements, CBD, COPD, COVID


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Dozens of speakers gave presentations at the 22nd Annual Geriatric and Long-Term Care Update Conference held September 16-18 at the UAMS Donald W. Reynolds Institute on Aging.

“When in doubt, avoid taking botanical supplements with conventional medications,” said Bill Gurley, Ph.D. “If you have to, take them at least four hours apart. There are some who will still have interactions even after that. Call your pharmacist if you have any questions.

Gurley is the senior scientist and director of the Clinical Research Center at the National Center for Natural Products at the University of Mississippi. He is also the former vice-president of the Department of Pharmaceutical Sciences of the College of Pharmacy at UAMS.

He was one of dozens of speakers at the 22nd Annual Geriatrics and Long-Term Care Update Conference held September 16-18 in UAMS Donald W. Reynolds Institute on Aging. The conference is also supported annually by Jeanne Wei, MD, Ph.D., Executive Director of the Institute on Aging.

More than 160 people attended the conference, which provides the latest information on the aging population to doctors and other health professionals, as well as caregivers. It aims to educate the public on the latest standards and evidence-based outcomes in geriatric medicine and long-term care management. Most of the audience listened via a live video stream, due to the ongoing COVID-19 pandemic.

“It always amazes me how few medical professionals have an appreciation for the large number of people who actually take botanical dietary supplements and may even interact,” Gurley said. According to one estimate, 50% of all hospital patients take some kind of herbal supplement, but patients are rarely asked about them.

Some supplements, especially those intended for weight loss, contain the equivalent of three to six cups of coffee. That doesn’t sound like too much because a lot of people drink that much coffee a day, but when they take a botanical supplement, it’s equivalent to drinking all those cups at once, not over several hours, Gurley said.

St. John’s Wort is a “pretty decent” antidepressant, but it’s “probably the most problematic botanical,” Gurley said. He cited the case of a transplant patient who suffered organ rejection due to how one of her anti-rejection drugs interacted with the St. John’s Wort she was taking.

Gurley has made two consecutive presentations. His second focused on another herbal supplement, cannabidiol (CBD).

“We live in a world of CBD,” he said. “This is the best-selling herb in the United States. It comes in a myriad of forms. However, the FDA does not recognize them for any regulatory reason. “

CBD is not intoxicating or hallucinogenic, and it can be an effective nausea medication and can help reduce inflammation and pain. Although many supporters and promoters of CBD claim that it can cure almost anything, clinical and scientific data only supports its use in the treatment of opioid addiction, mild anxiety, and in some cases, pain. ‘epilepsy.

Even then, there are no good guidelines as to the proper dosages, for how long or how it can be used with other medications, Gurley said.


Chronic obstructive pulmonary disease (COPD) in older Americans has been treated with Manish joshi, MD, professor of medicine in the UAMS Division of Pulmonary and Critical Care Medicine in the Department of Internal Medicine. COPD is one of the leading causes of death in the United States and its prevalence is expected to increase dramatically by 2030.

Each drug treatment for COPD should be individualized and guided by the severity of symptoms, risk of exacerbations, side effects, other medical conditions the patient has in addition to COPD, availability and cost of drugs, Joshi said. .

Rehabilitation should improve symptoms, quality of life and participation in daily activities. Too often, pulmonary rehabilitation for COPD is ruled out due to the patient’s frailty, he said.

The symptom burden in patients with severe COPD is high and comparable to that of cancer patients in terms of function and quality of life, Joshi said. A palliative care approach to a COPD patient increases the quality of life and perhaps even the quality of death.

They carry the burden longer than cancer patients. Therefore, while rehabilitation and drug therapy cannot change a patient’s outcome and quality of life, end-of-life discussions between the physician, patient, and patient’s family may need to take place. said Joshi.


Earlier in the conference, Atul Kothari, MD, presented the latest information on COVID-19 and its treatment.

Kothari is the Senior Medical Specialist in the Outbreak Response and Nosocomial Infections Directorate of the Arkansas Department of Health.

“While we still feel overwhelmed by COVID-19, we’ve come a long way in a year and a half,” Kothari said.

In 18 months, public health authorities and medical professionals have acquired effective vaccines, stepped up genetic sequencing and developed new therapies, he said.

“Use the infodemic to your advantage. There is a lot of literature there, ”Kothari said. “Continue to talk to your patients and families, they will share their hesitations and fears with you. Don’t force them. It’s a pandemic, not a sprint. It is a medical illness. Treat it like a medical illness. We have the tools.


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