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老年患者的药物治疗

[Pharmacotherapy of elderly patients].

作者信息

Burkhardt H, Wehling M, Gladisch R

机构信息

Universität Heidelberg, Medizinische Fakultät Mannheim, IV. Medizinische Klinik, SP Geriatrie u. Zentr. f. Gerontopharmakologie, Universitätsklinikum Mannheim, 68135, Mannheim, Deutschland.

出版信息

Internist (Berl). 2007 Nov;48(11):1220,1222-4, 1226-31. doi: 10.1007/s00108-007-1947-1.

Abstract

There is a complex interaction between age-driven changes in physiology and functional limitations in the elderly, which influences the pharmacokinetics, pharmacodynamics and management of drug therapy. Another frequent characteristic is multimorbidity, which results in polypharmacy and is a major cause of adverse drug reactions due to drug-drug interactions. Furthermore there are special risks in the elderly, which may alter the risk-benefit analysis of drug therapy and renal impairment, falls and delirium are of particular significance. These factors are discussed in detail and preventive strategies are given to optimize drug therapy in this population. Furthermore, the risks of frequently prescribed drugs and drugs bearing special risks in the elderly are outlined.

摘要

老年人年龄驱动的生理变化与功能受限之间存在复杂的相互作用,这会影响药物治疗的药代动力学、药效学及管理。另一个常见特征是多病共存,这会导致多种药物联合使用,并且是药物相互作用引起药物不良反应的主要原因。此外,老年人还存在特殊风险,这可能会改变药物治疗的风险效益分析,而肾功能损害、跌倒和谵妄尤为重要。本文将详细讨论这些因素,并给出预防策略以优化该人群的药物治疗。此外,还概述了老年人常用药物及有特殊风险药物的风险。

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