Schiffman Susan S
Department of Psychiatry, Duke University Medical Center, Durham, North Carolina 27710-3259, USA.
Ann N Y Acad Sci. 2009 Jul;1170:725-9. doi: 10.1111/j.1749-6632.2009.03924.x.
Losses in taste perception as well as distortions of gustatory function occur with greater frequency in older individuals, and these changes are exacerbated by certain medical conditions, pharmacologic interventions, radiation, and exposure to toxic chemicals. Medications, especially drug-drug interactions, are the most significant yet underappreciated contributors to taste disorders in the elderly. Taste disorders frequently occur when the fraction of an orally administered drug dose that reaches the systemic circulation is markedly increased due to inhibition (by a coadministered drug) of the efflux transporter P-glycoprotein and/or inhibition of the cytochrome P450 metabolism system, which normally limit systemic availability of drugs. The supratherapeutic plasma drug concentrations that result from drug-drug interactions can induce a taste from the blood side of taste cells (intravascular taste), alter taste cell biochemistry, and/or modify other aspects of the taste pathways.
味觉感知丧失以及味觉功能紊乱在老年人中更为频繁地出现，并且这些变化会因某些疾病状况、药物干预、辐射以及接触有毒化学物质而加剧。药物，尤其是药物相互作用，是老年人味觉障碍最主要但却未得到充分重视的因素。当口服药物剂量中到达体循环的部分由于（同时服用的药物）对流出转运蛋白P糖蛋白的抑制和/或细胞色素P450代谢系统的抑制而显著增加时，味觉障碍经常会发生，而细胞色素P450代谢系统通常会限制药物的全身可用性。药物相互作用导致的超治疗血浆药物浓度可从味觉细胞的血液侧诱导出一种味道（血管内味觉），改变味觉细胞生物化学，和/或改变味觉通路的其他方面。
