Kuchta Ann, Golembiewski Julie
Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL 60612-7230, USA.
J Perianesth Nurs. 2004 Dec;19(6):415-24; quiz 425-7. doi: 10.1016/j.jopan.2004.08.005.
As the population ages, the use of multiple medications also increases. Polypharmacy (taking multiple drugs at a time) presents concerns to the perianesthesia nurse who is caring for the geriatric patient. The pharmacokinetics and pharmacodynamics of drugs are often altered in older adult patients. Adverse drug reactions and drug interactions occur more often in geriatric patients than in younger patients. For these reasons, the benefits and risks of multiple medications and the administration of certain types of drugs must be carefully considered in the elderly patient. The selection of any medication should be individually based on the benefits and risks. Adverse drug reactions play a significant role in hospitalization for the general population, and the elderly are more susceptible to these. These drug reactions often contribute to significant morbidity as well as mortality. Medications need to be considered carefully in the older adult patient, but perhaps more so in the perioperative/perianesthesia period. Drug interactions are diverse. The type of anesthesia may influence the patient's outcome, depending on the medications the patient is currently taking. The patient's response to the stress of surgery is also affected by individual medical conditions as well as medications the patient is currently receiving Polypharmacy, inappropriate medications, adverse drug reactions, drug-disease issues, and drug interactions in the geriatric population are concerns in the perioperative/perianesthesia setting.
随着人口老龄化，多种药物的使用也在增加。多重用药（同时服用多种药物）给护理老年患者的麻醉后护理护士带来了诸多担忧。老年患者的药物代谢动力学和药效学常常发生改变。与年轻患者相比，老年患者发生药物不良反应和药物相互作用的情况更为常见。基于这些原因，对于老年患者，必须仔细权衡多种药物的益处和风险以及某些类型药物的给药方式。任何药物的选择都应基于个体的益处和风险。药物不良反应在普通人群的住院治疗中起着重要作用，而老年人更容易受到这些不良反应的影响。这些药物反应往往会导致严重的发病率和死亡率。在老年患者中需要仔细考虑用药，但在围手术期/麻醉后护理期可能更应如此。药物相互作用多种多样。麻醉类型可能会影响患者的预后，这取决于患者当前正在服用的药物。患者对手术应激的反应也会受到个体医疗状况以及患者当前正在服用的药物的影响。老年人群中的多重用药、不适当用药、药物不良反应、药物与疾病问题以及药物相互作用都是围手术期/麻醉后护理环境中需要关注的问题。
