Burkhardt H, Wehling M
Klinische Geriatrie, IV. Medizinische Klinik, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, Mannheim, Germany.
Internist (Berl). 2010 Jun;51(6):737-47; quiz 748. doi: 10.1007/s00108-010-2582-9.
Pharmacotherapy in the elderly is a challenge as the real risk-benefit ratio of many drugs and treatment strategies often remains unknown in these patients. Furthermore there are some special adverse drug reactions such as falls and delirium not only occurring more often but also causing an increased proportion of adverse outcomes. Finally there is the phenomenon of multimorbidity and polypharmacy responsible for treatment errors and inadequate drug treatment. A comprehensive risk-benefit analysis is needed to avoid both under- and over-treatment. This analysis should cover patients preferences, vulnerability, resources and functionality. Some simple treatment rules may improve drug treatment in the elderly, but an improved characterization of drugs and treatment strategies with regard to the elderly is essential.
老年患者的药物治疗是一项挑战，因为许多药物和治疗策略在这些患者中的实际风险效益比往往仍不明确。此外，还存在一些特殊的药物不良反应，如跌倒和谵妄，不仅更常发生，而且导致不良后果的比例增加。最后，存在多种疾病和多种药物治疗的现象，这会导致治疗错误和药物治疗不足。需要进行全面的风险效益分析，以避免治疗不足和过度治疗。这种分析应涵盖患者的偏好、脆弱性、资源和功能。一些简单的治疗规则可能会改善老年患者的药物治疗，但改进对老年患者药物和治疗策略的描述至关重要。
