Beers M H, Ouslander J G
UCLA Multicampus Division of Geriatric Medicine, Los Angeles.
Drugs. 1989 Jan;37(1):105-12. doi: 10.2165/00003495-198937010-00008.
Although the use of medication has helped to cure and control disease, it has also led to serious iatrogenic illness. Toxicity is most common and severe in the elderly. Confusion, falls, depression, sedation, deterioration of function, and urinary incontinence and retention are frequently the manifestation of that toxicity. Normal ageing places older patients at risk because of changes in metabolism, distribution, and excretion of drugs, and sensitivity to drug effects is often greater in the elderly. Disease and the interactions of other drugs can increase the incidence and severity of side effects. Certain drugs should be avoided in the elderly. Those that are long acting and require hepatic metabolism, those with strong anticholinergic properties, and those that are highly sedating tend to cause the most problems. In every case, physicians must weigh the potential benefit of prescribing against the potential risk.
尽管药物的使用有助于治愈和控制疾病，但它也导致了严重的医源性疾病。毒性在老年人中最为常见且严重。意识模糊、跌倒、抑郁、镇静、功能衰退以及尿失禁和尿潴留常常是那种毒性的表现。正常衰老使老年患者面临风险，因为药物的代谢、分布和排泄会发生变化，而且老年人对药物作用的敏感性往往更高。疾病和其他药物的相互作用会增加副作用的发生率和严重程度。老年人应避免使用某些药物。那些长效且需要肝脏代谢的药物、具有强烈抗胆碱能特性的药物以及那些具有高度镇静作用的药物往往会引发最多问题。在每种情况下，医生都必须权衡开药的潜在益处与潜在风险。
