Shi Shaojun, Mörike Klaus, Klotz Ulrich
Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.
Eur J Clin Pharmacol. 2008 Feb;64(2):183-99. doi: 10.1007/s00228-007-0422-1. Epub 2008 Jan 5.
The proportion of the elderly is constantly increasing and by the year 2025 20% of the population will be above 65 years of age. With advanced age, subjects will develop multiple diseases and often need to take several drugs.
This polypharmacy increases the risk for drug interactions and adverse effects. In addition, age-related physiological changes affect different biological systems and can contribute to alterations in pharmacokinetics and pharmacodynamics in older patients, which are more often seen in the frail than in the fit elderly. These features will complicate drug therapy in the elderly, and a careful dose titration is advisable. Furthermore, inappropriate drug prescription and non-adherence to medication represent common therapeutic challenges in elderly subjects. To date, there is no evidence of any effective antiageing agent.
This review summarizes present knowledge of age-related problems in drug action and their clinical implications for an increasingly important population.
老年人的比例在不断增加,到2025年,20%的人口将超过65岁。随着年龄的增长,人们会患上多种疾病,常常需要服用多种药物。
这种多药合用增加了药物相互作用和不良反应的风险。此外,与年龄相关的生理变化会影响不同的生物系统,并可能导致老年患者药代动力学和药效学的改变,这种情况在体弱的老年人中比在健康的老年人中更常见。这些特征会使老年患者的药物治疗复杂化,因此建议谨慎进行剂量滴定。此外,不适当的药物处方和不遵医嘱服药是老年患者常见的治疗挑战。迄今为止,尚无任何有效抗衰老药物的证据。
本综述总结了目前关于药物作用中与年龄相关问题的知识及其对这一日益重要人群的临床意义。