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[老年期的药物与跌倒]

[Medication and falls in old age].

作者信息

Modreker M K, von Renteln-Kruse W

机构信息

Medizinisch-Geriatrische Klinik, Albertinen-Haus, Zentrum für Geriatrie und Gerontologie, Wiss. Einrichtung an der Universität Hamburg, Sellhopsweg 18-22, Hamburg, Germany.

出版信息

Internist (Berl). 2009 Apr;50(4):493-500. doi: 10.1007/s00108-009-2355-5.

Abstract

Falls with and without injuries in elderly persons commonly have multiple causes. Exposure to drugs does contribute to these causes. Therefore, complete assessment and evaluation of prescription and over the counter drugs are essential parts of fall-prevention concepts. Frail elderly persons frequently treated with several medications are particularly predisposed to adverse drug effects which may increase the risk of falling. Risk increasing drug effects are dose dependent which have been best studied with psychotropic medication. Apart from psychotropic drugs, cardiovascular drugs contribute to FRIDs (Fall-Risk Increasing Drugs). Fall risk is particularly increased with drugs of the same therapeutic class combined or combinations of psychotropics and cardiovascular drugs. Intervention studies on withdrawal and dose reduction of fall-risk increasing drugs were successful in reducing the risk of falling. There is relatively few knowledge on whether and how drug treatment does decrease fall risk in elderly patients by improving safe mobility and walking ability relevant to activities of daily living.

摘要

老年人跌倒无论是否受伤通常都有多种原因。药物暴露是这些原因之一。因此,全面评估和评价处方药和非处方药是预防跌倒概念的重要组成部分。经常服用多种药物的体弱老年人特别容易出现药物不良反应,这可能会增加跌倒风险。增加风险的药物效应具有剂量依赖性,这在精神药物方面研究得最为充分。除了精神药物外,心血管药物也会导致增加跌倒风险的药物(FRIDs)。同一治疗类别的药物联合使用或精神药物与心血管药物联合使用时,跌倒风险会特别增加。关于减少增加跌倒风险药物的停药和剂量减少的干预研究在降低跌倒风险方面取得了成功。关于药物治疗是否以及如何通过改善与日常生活活动相关的安全移动性和行走能力来降低老年患者跌倒风险的知识相对较少。

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