Lynch R A, Horowitz L N
Presbyterian Medical Center, Philadelphia.
Geriatrics. 1991 Apr;46(4):41-4, 49-52, 54.
Age-related impairments in antiarrhythmic drug distribution, metabolism, and excretion may result in accumulation of these potent drugs, increasing the risk of adverse drug reactions and drug interactions in the elderly. These risks are minimized by using modest initial dosage with slow dosage titration. Therapeutic drug monitoring is a method which employs antiarrhythmic concentration data and a determination of drug clearance in order to develop an optimal dosing regimen. The pharmacology, indications for use, and adverse effects of currently available antiarrhythmics are reviewed. Dosing guidelines for the geriatric population are provided.
抗心律失常药物分布、代谢和排泄方面与年龄相关的损害可能导致这些强效药物的蓄积，增加老年人发生药物不良反应和药物相互作用的风险。通过采用适度的初始剂量并缓慢滴定剂量可将这些风险降至最低。治疗药物监测是一种利用抗心律失常药物浓度数据和药物清除率测定结果来制定最佳给药方案的方法。本文综述了目前可用的抗心律失常药物的药理学、使用指征和不良反应。并提供了老年人群的给药指南。
