Cobaugh Daniel J, Krenzelok Edward P
American Society of Health-System Pharmacists Research and Education Foundation, Bethesda, MD 20814, USA.
Am J Health Syst Pharm. 2006 Nov 15;63(22):2228-34. doi: 10.2146/ajhp050280.
The severity of hazards posed by medications implicated in poisoning in older adults was characterized.
Toxic Exposure Surveillance System (TESS) cases from 1993 through 2002 involving a single substance in patients age 60 years or older and coded as an adverse drug reaction (ADR) or therapeutic error were analyzed. Hazard factors were determined for each exposure reason by calculating the sum of the major effects and deaths for each substance category and subcategory and dividing this by the total number of exposures for the respective category or subcategory.
Hazard factors were calculated for 12,737 ADRs and 51,846 therapeutic errors. The overall rates of major effects and deaths were 7.5% and 1.6% in the ADR and therapeutic error groups, respectively. In the ADR group, five TESS categories had a hazard factor of > or =2.0: anesthetics, anticoagulants, antineoplastics, cardiovascular drugs, and radiopharmaceuticals. In the therapeutic error group, five drug categories also had a hazard factor of > or =2.0: anesthetics, anticoagulants, antineoplastics, asthma therapies, and serums/toxoids/vaccines. Six pharmaceutical categories were associated with hazard factors of > or =2.0 in both the ADR and therapeutic error groups.
An analysis of ADRs and therapeutic errors involving older adults and reported to poison control centers from 1993 through 2002 revealed overall rates of major effects and death of 7.5% and 1.6% in the ADR and therapeutic error groups, respectively. Antineoplastics, aminophylline or theophylline, cardiac glycosides, heparin, morphine, and warfarin were implicated in more than 50 cases and associated with hazard factors of > or =2.0 for both exposure groups.
对涉及老年人中毒的药物所造成危害的严重程度进行特征描述。
分析了1993年至2002年来自毒物暴露监测系统（TESS）的病例，这些病例涉及60岁及以上患者的单一物质，且编码为药物不良反应（ADR）或治疗错误。通过计算每种物质类别和亚类的主要影响和死亡人数之和，并将其除以相应类别或亚类的暴露总数，确定每种暴露原因的危险因素。
计算了12737例ADR和51846例治疗错误的危险因素。ADR组和治疗错误组的主要影响和死亡总发生率分别为7.5%和1.6%。在ADR组中，有5个TESS类别危险因素≥2.0：麻醉药、抗凝剂、抗肿瘤药、心血管药物和放射性药物。在治疗错误组中，也有5类药物危险因素≥2.0：麻醉药、抗凝剂、抗肿瘤药、哮喘治疗药物以及血清/类毒素/疫苗。在ADR组和治疗错误组中，有6类药物的危险因素≥2.0。
对1993年至2002年向中毒控制中心报告的涉及老年人的ADR和治疗错误进行分析，结果显示ADR组和治疗错误组的主要影响和死亡总发生率分别为7.5%和1.6%。抗肿瘤药、氨茶碱或茶碱、强心苷、肝素、吗啡和华法林涉及50多例病例，且两个暴露组的危险因素均≥2.0。
