Breithaupt H
Medizinische Klinik, Giessen.
Z Rheumatol. 1992 Nov-Dec;51(6):301-4.
Drug treatment in the polymorbid elderly should focus on the more important symptoms. Pharmacokinetic differences should be considered, e.g. a reduced volume of distribution and decreased liver and renal function. Special alterations in the pharmacodynamics with respect to the central nervous system and other organs are important. Drug therapy in the elderly has to be done very cautiously. The indication, dosage and duration of therapy has to be evaluated again and again. Antirheumatics in the elderly should improve the quality of life avoiding untowanted side effects, especially of the gastrointestinal tract, the renal function and bone marrow. Non-narcotic analgesics and opioids may be helpful, when antirheumatics were not tolerated.
多病共存的老年人的药物治疗应侧重于更重要的症状。应考虑药代动力学差异，例如分布容积减小以及肝肾功能下降。关于中枢神经系统和其他器官的药效学特殊改变也很重要。老年人的药物治疗必须非常谨慎。治疗的适应证、剂量和疗程必须反复评估。老年人使用抗风湿药应在避免出现不良副作用，尤其是胃肠道、肾功能和骨髓方面副作用的前提下提高生活质量。当无法耐受抗风湿药时，非麻醉性镇痛药和阿片类药物可能会有所帮助。
