Janice Schwartz, MD

Professor of Medicine

Geriatrics

I graduated from Tulane Medical School, am a board-certified internist and cardiologist with significant experience in clinical pharmacology and geriatric medicine. My research goal has been to elucidate age-related and sex-related differences in pharmacokinetics and pharmacodynamics in order to improve medication therapy for older people. I have studied models of aging from in vitro models of cardiac changes with aging to physiologic and pharmacokinetic investigations of healthy humans to population studies of community dwelling elderly, and most recently, frail elderly people.

My current work focuses on improving medication and vitamin use in the very oldest people, in optimizing outcomes in older people receiving polypharmacy, and the translation of new therapies and devices into clinical use to benefit the very oldest and frailest patients. to this end, I am working with the Office of Clinical Pharmacology at the FDA through an ORISE visiting Professorship. My efforts include trying to improve the drug evaluation and monitoring process for older adults, and translating medical knowledge related to aging and cardiovascular health for the public.

Education
1990 - Geriatrics, UCLA
1981 - Cardiology, Stanford University
1978 - Cardiology, Cedar Sinai Medical Center
1977 - Internal Medicine, Cedar-Sinai Medical Center
1975 - Internal Medicine, LACounty/USC
MD, 1974 - Medicine, Tulane University, School of Medicine
1970 - Biology, Newcomb College
Honors and Awards
  • Award of Excellence in Clinical Pharmacology, PhRMA, 2019
  • William Abrams Award in Geriatric Clinical Pharmacology, American Society of Clinical Pharmacology and Therapeutics, 2012
Publications
  1. Prevalence and Knowledge of Potential Interactions Between Over-the-Counter Products and Apixaban.
  2. Apixaban Concentrations with Lower than Recommended Dosing in Older Adults with Atrial Fibrillation.
  3. Pharmacotherapy Research Priorities in Older Adults With Cardiovascular Disease in Nursing Homes, Assisted Living, and Home Care: Report From a Satellite Symposium of the ACC, AGS, NIA Workshop.
  4. Complement protein levels in plasma astrocyte-derived exosomes are abnormal in conversion from mild cognitive impairment to Alzheimer's disease dementia.
  5. Pharmacotherapy in Older Adults with Cardiovascular Disease: Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop.
  6. Determination of Free 25(OH)D Concentrations and Their Relationships to Total 25(OH)D in Multiple Clinical Populations.
  7. Editorial Commentary: Blood pressure and cognition in the elderly.
  8. Deficient neurotrophic factors of CSPG4-type neural cell exosomes in Alzheimer disease.
  9. Medication burden attributable to chronic co-morbid conditions in the very old and vulnerable.
  10. High complement levels in astrocyte-derived exosomes of Alzheimer disease.
  11. Farewell to Our Good Friend, Outstanding Mentor, and Colleague Darrell R. Abernethy (1949-2017).
  12. Declining levels of functionally specialized synaptic proteins in plasma neuronal exosomes with progression of Alzheimer's disease.
  13. Authors Have Incorrectly Calculated Need for Renal Dose Adjustments for NOACs.
  14. Dosing Accuracy of Direct Oral Anticoagulants in an Academic Medical Center.
  15. Altered cargo proteins of human plasma endothelial cell-derived exosomes in atherosclerotic cerebrovascular disease.
  16. Dabigatran Compared With Rivaroxaban vs Warfarin.
  17. Letter to the Editor: "Effects of Testosterone Replacement on Electrocardiographic Parameters in Men: Findings From Two Randomized Trials".
  18. Pharmacokinetics and Saturable Absorption of Gabapentin in Nursing Home Elderly Patients.
  19. Potential impact of substituting estimated Glomerular Filtration Rate for estimated Creatinine Clearance for dosing of Direct Oral Anticoagulants
  20. Decreased synaptic proteins in neuronal exosomes of frontotemporal dementia and Alzheimer's disease.
  21. Potential Effect of Substituting Estimated Glomerular Filtration Rate for Estimated Creatinine Clearance for Dosing of Direct Oral Anticoagulants.
  22. Cargo proteins of plasma astrocyte-derived exosomes in Alzheimer's disease.
  23. Response of Vitamin D Concentration to Vitamin D3 Administration in Older Adults without Sun Exposure: A Randomized Double-Blind Trial.
  24. Altered lysosomal proteins in neural-derived plasma exosomes in preclinical Alzheimer disease.
  25. Low neural exosomal levels of cellular survival factors in Alzheimer's disease.
  26. Cardiovascular physiology in the older adults.
  27. Total 25(OH) vitamin D, free 25(OH) vitamin D and markers of bone turnover in cirrhotics with and without synthetic dysfunction.
  28. Dysfunctionally phosphorylated type 1 insulin receptor substrate in neural-derived blood exosomes of preclinical Alzheimer's disease.
  29. Primary prevention: do the very elderly require a different approach?
  30. Identification of preclinical Alzheimer's disease by a profile of pathogenic proteins in neurally derived blood exosomes: A case-control study.
  31. Prescribing quality in older veterans: a multifocal approach.
  32. Patterns of chronic co-morbid medical conditions in older residents of U.S. nursing homes: differences between the sexes and across the agespan.
  33. Relationship of vitamin D, HIV, HIV treatment, and lipid levels in the Women's Interagency HIV Study of HIV-infected and uninfected women in the United States.
  34. Variability in free 25(OH) vitamin D levels in clinical populations.
  35. Vitamin D3 effects on lipids differ in statin and non-statin-treated humans: superiority of free 25-OH D levels in detecting relationships.
  36. Aging enhances release of exosomal cytokine mRNAs by Aß1-42-stimulated macrophages.
  37. Patterns of multimorbidity in elderly veterans.
  38. Distinct energy requirements for human memory CD4 T-cell homeostatic functions.
  39. Age and sex variation in prevalence of chronic medical conditions in older residents of U.S. nursing homes.
  40. Distinctive immunoregulatory effects of adenosine on T cells of older humans.
  41. Defective T cell chemotaxis to sphingosine 1-phosphate and chemokine CCL21 in idiopathic T lymphocytopenia.
  42. Effects of testosterone on the Q-T interval in older men and older women with chronic heart failure.
  43. Failure of pharmacogenetic-based dosing algorithms to identify older patients requiring low daily doses of warfarin.
  44. Preferential enhancement of older human T cell cytokine generation, chemotaxis, proliferation and survival by lenalidomide.
  45. Gender specificity of altered human immune cytokine profiles in aging.
  46. Population analyses of atorvastatin clearance in patients living in the community and in nursing homes.
  47. Clin Pharmacol Ther
  48. Clin Pharmacol Ther
  49. Effects of vitamin D supplementation in atorvastatin-treated patients: a new drug interaction with an unexpected consequence.
  50. The current state of knowledge on age, sex, and their interactions on clinical pharmacology.
  51. Sex differences in major bleeding with glycoprotein IIb/IIIa inhibitors: results from the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) initiative.
  52. Erythromycin breath test results in elderly, very elderly, and frail elderly persons.
  53. Population analyses of amlodipine in patients living in the community and patients living in nursing homes.
  54. Sample size computations for PK/PD population models.
  55. What does the Medicare prescription drug legislation mean for the American cardiologist?
  56. Estrogen and progestin use and the QT interval in postmenopausal women.
  57. A sample size computation method for non-linear mixed effects models with applications to pharmacokinetics models.
  58. Sudden cardiac death among women in the United States.
  59. Gender-specific implications for cardiovascular medication use in the elderly optimizing therapy for older women.
  60. Population analyses of sustained-release verapamil in patients: effects of sex, race, and smoking.
  61. The influence of sex on pharmacokinetics.
  62. Pharmacologic agents for weight reduction.
  63. Peripheral arterial disease: drug therapy.
  64. Pharmacogenetics: has it reached the clinic?
  65. Anticoagulant and thrombolytic therapies in women.
  66. Drug Interactions in the Elderly With Coronary Artery Disease - Do These Interfere With Effective Therapy?
  67. Age-Related Pharmacodynamic Changes in the Elderly: Treatment Considerations in Heart Failure.