Scientific Direction, Italian National Research Center on Aging (INRCA), Ancona, Italy.
Drug Saf. 2012 Jan;35 Suppl 1:55-61. doi: 10.1007/BF03319103.
While polypathology and polypharmacy are well known risk factors for adverse drug reactions (ADRs), the association between geriatric conditions (GCs), i.e. a set of clinical and functional problems partly constitutive of and partly related to frailty, and ADRs is suspected but has not been fully elucidated. Several studies have assessed the relationship between single GCs and ADRs, but only a few studies have systematically evaluated the relationship between the whole spectrum of GCs and ADRs. The mechanism by which select GCs increase the risk of developing ADRs during a hospital stay might simply reflect a sort of general predictability of physical disability with respect to adverse outcomes. However, GCs pertaining to the physical dimension of frailty are generally associated with relevant changes in pharmacokinetics and pharmacodynamics of select drugs. While current evidence could not be considered either unequivocal or conclusive, select GCs, e.g. a history of falls and loss of independence in the activities of daily living, seem to define a condition of particular vulnerability of elderly patients to ADRs.
虽然多病理学和多药物治疗是已知的药物不良反应 (ADR) 的危险因素，但老年病学状况 (GCs) 与 ADR 之间的关联，即一组部分构成和部分与虚弱相关的临床和功能问题，被怀疑但尚未完全阐明。有几项研究评估了单一 GCs 与 ADRs 之间的关系，但只有少数研究系统地评估了整个 GCs 谱与 ADRs 之间的关系。在住院期间，某些 GCs 增加发生 ADRs 的风险的机制可能只是反映了身体残疾对不良结果的某种普遍可预测性。然而，与虚弱的身体维度相关的 GCs 通常与特定药物的药代动力学和药效学的相关变化相关。虽然目前的证据不能被认为是明确或结论性的，但某些 GCs，例如跌倒史和日常生活活动丧失独立性，似乎定义了老年患者对 ADRs 特别脆弱的一种情况。
