Ouanounou Aviv, Haas Daniel A
University of Toronto, Toronto ON.
J Can Dent Assoc. 2015;80:f18.
Current demographic data clearly show that the North American population is aging, and projections suggest that the percentage of older people will increase. The elderly often suffer from multiple chronic conditions that affect their quality of life, use of health services, morbidity and mortality. Also, in those of advanced age, the pharmacokinetics and pharmacodynamics of many drugs are altered. Polypharmacy increases the incidence of adverse drug reactions and drug interactions in this population. Thus, the dentist must be continually aware of the pharmacologic status of each patient and consider the likelihood of interactions between drugs prescribed by the dentist, drugs prescribed by the physician and drugs that are self-administered, including over-the-counter medications and natural supplements. In this article, we discuss pharmacokinetic and pharmacodynamic changes in the elderly patient, polypharmacy and the changes in prescribing for our dental patients. Specific emphasis is placed on the drugs commonly prescribed by dentists: local anesthetics, analgesics and antibiotics.
当前的人口统计数据清楚地表明，北美人口正在老龄化，并且预测显示老年人的比例将会增加。老年人常常患有多种慢性疾病，这些疾病会影响他们的生活质量、医疗服务的使用、发病率和死亡率。此外，在高龄人群中，许多药物的药代动力学和药效学都会发生改变。多重用药增加了该人群中药物不良反应和药物相互作用的发生率。因此，牙医必须持续了解每位患者的用药情况，并考虑牙医所开药物、医生所开药物以及患者自行服用的药物（包括非处方药物和天然补充剂）之间相互作用的可能性。在本文中，我们将讨论老年患者的药代动力学和药效学变化、多重用药情况以及我们牙科患者处方的变化。特别强调的是牙医常用的药物：局部麻醉剂、镇痛药和抗生素。
