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老年人的心血管药物治疗

Cardiovascular drug therapy in the elderly.

作者信息

Aronow Wilbert S, Frishman William H, Cheng-Lai Angela

机构信息

Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, New York 10595, USA.

出版信息

Cardiol Rev. 2007 Jul-Aug;15(4):195-215. doi: 10.1097/CRD.0b013e3180301b69.

Abstract

Pharmacokinetic considerations in the elderly include absorption, bioavailablility, drug distribution, half-life, drug metabolism, and drug excretion. There are numerous physiologic changes with aging that affect pharmacodynamics with alterations in end-organ responsiveness. This article discusses use of cardiovascular drugs in the elderly including digoxin, diuretics, beta-adrenergic blockers, angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, nitrates, calcium channel blockers, alpha-adrenergic blockers, antiarrhythmic drugs, lipid-lowering drugs, and anticoagulants. This article also discusses the adverse effects of cardiovascular drugs in the elderly, medications best to avoid in the elderly, and the prudent use of medications in the elderly.

摘要

老年人的药代动力学考量包括吸收、生物利用度、药物分布、半衰期、药物代谢和药物排泄。随着年龄增长会出现许多生理变化,这些变化会通过终末器官反应性的改变影响药效学。本文讨论了老年人使用的心血管药物,包括地高辛、利尿剂、β肾上腺素能阻滞剂、血管紧张素转换酶抑制剂、血管紧张素II受体阻滞剂、硝酸盐、钙通道阻滞剂、α肾上腺素能阻滞剂、抗心律失常药物、降脂药物和抗凝剂。本文还讨论了心血管药物在老年人中的不良反应、老年人最好避免使用的药物以及老年人用药的谨慎之处。

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