Universidade Estadual de Londrina, Londrina, PR, Brazil.
Clinics (Sao Paulo). 2009;64(4):273-8. doi: 10.1590/s1807-59322009000400002.
The objective of this study was to analyze medications that act on the cytochrome P450 (CYP450) enzymatic system and are used daily by non-institutionalized elderly individuals.
A cross-sectional population-based study of elderly individuals (> or = 60 years old) was conducted. All continuously used medications with hepatic metabolism via CYP450 that are classified as substrates, inducers or inhibitors were considered. For the analysis, elderly individuals were stratified according to age groups, and hepatic metabolism activity due to daily alcohol consumption and smoking were considered.
Elderly individuals (396 in total: 222 women and 174 men) between 60 and 95 years of age (mean: 72.1) were assessed. Use of drugs that act on CYP450 was identified in 61.6% of the subjects. Drug use was observed among 16.2% of the subjects: three drugs among 9.8% and four or more among 6.3% of the subjects. The metabolic activities of the drugs used were classified as substrates (58.8%), inhibitors (14.9%), and inducers (4.3%). The main drugs used were beta-blockers and statins (as substrates), proton pump inhibitors and fluoxetine (as inhibitors), and prednisone and carbamazepine (as inducers).
The results demonstrate that the elderly use high levels of medications that act on CYP450, thereby increasing the risk of drug interactions in a group that is already vulnerable to adverse drug effects.
本研究旨在分析经细胞色素 P450（CYP450）酶系统作用且被非住院老年个体每日使用的药物。
进行了一项基于人群的横断面研究，研究对象为老年个体（≥60 岁）。所有具有经 CYP450 代谢的肝代谢且被归类为底物、诱导剂或抑制剂的持续使用药物均被考虑在内。在分析中，根据年龄组对老年个体进行分层，并考虑了因每日饮酒和吸烟导致的肝代谢活性。
评估了年龄在 60 至 95 岁之间（平均年龄为 72.1 岁）的 396 名老年个体（其中 222 名女性和 174 名男性）。61.6%的受试者使用了作用于 CYP450 的药物。16.2%的受试者使用了药物：9.8%的受试者使用了三种药物，6.3%的受试者使用了四种或更多药物。所使用药物的代谢活性被归类为底物（58.8%）、抑制剂（14.9%）和诱导剂（4.3%）。主要使用的药物为β受体阻滞剂和他汀类药物（作为底物）、质子泵抑制剂和氟西汀（作为抑制剂）以及泼尼松和卡马西平（作为诱导剂）。
结果表明，老年人使用了高水平的作用于 CYP450 的药物，从而增加了药物相互作用的风险，而老年人群已经容易受到药物不良反应的影响。
