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从临床药理学家角度看老年患者的药物治疗

[Drug therapy of elderly patients from the viewpoint of the clinical pharmacologist].

作者信息

Wehling M, Peiter A

机构信息

Zentrum für Gerontopharmakologie, Institut für Klinische Pharmakologie, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg.

出版信息

Internist (Berl). 2003 Aug;44(8):1003-9. doi: 10.1007/s00108-003-0950-4.

Abstract

Polypragmasy (polypharmacotherapy) is often due to the frequent incidence of multimorbidity among elderly patients. This may evoke unpredictable drug-interactions, which often become a reason for hospitalization. Additional medications might be the consequence. Geriatric patients are often characterized by variant pharmacokinetic parameters. Individualized drug-therapy should take into consideration not only the patients' age, liver and kidney functions but also the individual variability of hepatic metabolization and drug-resorption in the intestine based on genetic polymorphisms. Summing up, it is very important to verify a consisting or a new drug-therapy concerning its risk-benefit ratio and if it is needed, to omit or change some of the medications.

摘要

多病同治(多药联合治疗)通常是由于老年患者中多种疾病的高发率所致。这可能引发不可预测的药物相互作用,而这往往成为住院的原因。额外用药可能就是其结果。老年患者通常具有不同的药代动力学参数。个体化药物治疗不仅应考虑患者的年龄、肝肾功能,还应考虑基于基因多态性的肝脏代谢和肠道药物吸收的个体变异性。总之,核实现有或新的药物治疗的风险效益比,并在必要时省略或更改某些药物,这非常重要。

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