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老年人的性别差异、多种药物治疗和潜在的药物相互作用。

Gender differences, polypharmacy, and potential pharmacological interactions in the elderly.

机构信息

Instituto de Geriatria e Gerontologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

出版信息

Clinics (Sao Paulo). 2011;66(11):1867-72. doi: 10.1590/s1807-59322011001100004.

Abstract

OBJECTIVE

This study aims to analyze pharmacological interactions among drugs taken by elderly patients and their age and gender differences in a population from Porto Alegre, Brazil.

METHODS

We retrospectively analyzed the database provided by the Institute of Geriatric and Gerontology, Porto Alegre, Brazil. The database was composed of 438 elderly and includes information about the patients' disease, therapy regimens, utilized drugs. All drugs reported by the elderly patients were classified using the Anatomical Therapeutic and Chemical Classification System. The drug-drug interactions and their severity were assessed using the Micromedex® Healthcare Series.

RESULTS

Of the 438 elderly patients in the data base, 376 (85.8%) used pharmacotherapy, 274 were female, and 90.4% of females used drugs. The average number of drugs used by each individual younger than 80 years was 3.2±2.6. Women younger than 80 years old used more drugs than men in the same age group whereas men older than 80 years increased their use of drugs in relation to other age groups. Therefore, 32.6% of men and 49.2% of women described at least one interaction, and 8.1% of men and 10.6% of women described four or more potential drug-drug interactions. Two-thirds of drug-drug interactions were moderate in both genders, and most of them involved angiotensin-converting enzyme inhibitor, non-steroidal anti-inflammatory, loop and thiazide diuretics, and β-blockers.

CONCLUSION

Elderly patients should be closely monitored, based on drug class, gender, age group and nutritional status.

摘要

目的

本研究旨在分析巴西阿雷格里港老年患者所服用药物之间的药物相互作用及其与年龄和性别差异的关系。

方法

我们回顾性分析了巴西阿雷格里港老年医学与老年学研究所提供的数据库。该数据库由 438 名老年人组成,包含患者疾病、治疗方案和使用药物的信息。所有报告的老年人药物均采用解剖治疗化学分类系统进行分类。使用 Micromedex® Healthcare Series 评估药物-药物相互作用及其严重程度。

结果

在数据库中的 438 名老年人中,376 名(85.8%)接受了药物治疗,274 名是女性,90.4%的女性使用药物。年龄小于 80 岁的个体平均使用药物 3.2±2.6 种。年龄小于 80 岁的女性比同年龄组的男性使用更多的药物,而 80 岁以上的男性与其他年龄组相比,增加了药物的使用。因此,32.6%的男性和 49.2%的女性至少描述了一种相互作用,8.1%的男性和 10.6%的女性描述了四种或更多潜在的药物-药物相互作用。两性的药物-药物相互作用中,有三分之二为中度,且大多数涉及血管紧张素转换酶抑制剂、非甾体抗炎药、环和噻嗪类利尿剂以及β受体阻滞剂。

结论

应根据药物类别、性别、年龄组和营养状况密切监测老年患者。

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