de Baat C, van der Putten G J, Visser A, Vissink A
Ned Tijdschr Tandheelkd. 2017 May;124(5):265-270. doi: 10.5177/ntvt.2017.05.16244.
Polypharmacy is the consequence of multimorbidity. Both phenomena may cause functional limitations and/or frailty and/or care dependency in older people. In the human body, a medicament undergoes at least 3 important actions: absorption, distribution and elimination. These actions may proceed aberrantly in older people. Following interaction with receptors, a medicament triggers a chain reaction in the human body. The receptors and each link of the chain reaction may be subject to changes due to diseases as well as ageing. This, particularly, is the case with regard to medications directed towards the central nervous system and the cardiovascular system. Furthermore, interactions may occur between various medications mutually and between medications on the one hand and on the other hand food and water intake, self-medication with herbs, and diseases. Moreover, older people usually experience more adverse effects of medications when compared to younger people. This is due to altered body actions and reactions, polypharmacy and the many possible interactions. In older people, utilisation and intake of medications often give rise to problems that can be divided into medicament-related, patient-related, care- and care provider-related and other problems.
多重用药是多种疾病并存的结果。这两种现象都可能导致老年人出现功能受限和/或身体虚弱和/或护理依赖。在人体中,药物至少会经历三个重要过程:吸收、分布和消除。这些过程在老年人身上可能会异常进行。与受体相互作用后,药物会在人体内引发连锁反应。由于疾病以及衰老,受体和连锁反应的每个环节都可能发生变化。对于针对中枢神经系统和心血管系统的药物来说尤其如此。此外,各种药物之间、药物与食物和水的摄入、草药的自我用药以及疾病之间都可能发生相互作用。而且,与年轻人相比,老年人通常更容易出现药物不良反应。这是由于身体的作用和反应发生了改变、多重用药以及许多可能的相互作用。在老年人中,药物的使用和摄入常常会引发一些问题,这些问题可分为与药物相关、与患者相关、与护理及护理提供者相关以及其他问题。