Bsoul Samer A, Terezhalmy Geza
Department of Dental Diagnostic Science, University of Texas Health Science Center, San Antonio Dental School, USA.
Gen Dent. 2007 May-Jun;55(3):238-43; quiz 244, 264.
The rational use of drugs in older persons is a challenging area of clinical practice. The increased incidence of multiple chronic illnesses contributes to disproportionately high use of prescription and over-the-counter (OTC) medications, which in turn leads to more adverse drug events among the elderly. Inadequate nutrition and poor patient compliance also may contribute to the problem. Drug studies that use young adult subjects cannot be extrapolated accurately to apply to the elderly because physiologic changes that occur with age affect the pharmacokinetics and pharmacodynamics of drugs. In addition, therapeutic target concentrations of drugs are impossible to define due to marked interindividual variation in the elderly population. Drugs should be administered to elderly patients only when absolutely necessary. The dosages should be titrated to a clearly defined clinical response and dentists should avoid drugs that are known to be problematic for older adults.
老年人合理用药是临床实践中一个具有挑战性的领域。多种慢性疾病发病率的增加导致处方药和非处方药（OTC）的使用比例过高，这反过来又导致老年人中更多的药物不良事件。营养不足和患者依从性差也可能导致这一问题。使用年轻成年受试者的药物研究不能准确外推应用于老年人，因为随着年龄增长发生的生理变化会影响药物的药代动力学和药效学。此外，由于老年人群个体差异显著，药物的治疗目标浓度无法确定。只有在绝对必要时才应给老年患者用药。剂量应根据明确的临床反应进行调整，牙医应避免使用已知对老年人有问题的药物。
