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营养与多药治疗的新进展。

Updates in nutrition and polypharmacy.

机构信息

Saint Louis University Medical Center, Saint Louis, Missouri, USA.

出版信息

Curr Opin Clin Nutr Metab Care. 2018 Jan;21(1):4-9. doi: 10.1097/MCO.0000000000000425.

Abstract

PURPOSE OF REVIEW

Medications have the potential to affect nutritional status in negative ways, especially as the number of medications increase. The inter-relation between polypharmacy and malnutrition is complex and not fully delineated in previous studies. More research has been done and compiled in the last year, which helps to clarify this relationship. This review brings together the most recent literature with the previous research to help healthcare providers to better assess and manage medication therapy in older adults.

RECENT FINDINGS

Recent evidence confirms a synergistic negative effect of polypharmacy and malnutrition on outcomes of older adults. In addition, several drug classes, including common antihypertensive agents, acetylcholinesterase inhibitors, multivitamins, proton pump inhibitors, HMG-CoA reductase inhibitors (statins), antiplatelet agents and metformin, have been implicated in important drug-nutrient interactions. These are reviewed in detail here. Ongoing research endeavors are described.

SUMMARY

Healthcare practitioners can use this review to identify potentially inappropriate medications and patients at highest risk of experiencing a medication-related adverse reaction in order to systematically deprescribe these high-risk medications.

摘要

目的综述

药物有可能以负面的方式影响营养状况,尤其是随着用药数量的增加。以前的研究并未充分描述多种药物治疗与营养不良之间的复杂关系。过去一年中进行了更多的研究,并进行了综合,这有助于阐明这种关系。本综述汇集了最新的文献和以前的研究,以帮助医疗保健提供者更好地评估和管理老年人的药物治疗。

最近的发现

最近的证据证实了多种药物治疗和营养不良对老年人结局的协同负面影响。此外,一些药物类别,包括常用的降压药、乙酰胆碱酯酶抑制剂、多种维生素、质子泵抑制剂、HMG-CoA 还原酶抑制剂(他汀类药物)、抗血小板药物和二甲双胍,都与重要的药物-营养素相互作用有关。本文对此进行了详细回顾。还描述了正在进行的研究工作。

总结

医疗保健从业者可以使用本综述来识别潜在的不适当药物和最有可能经历药物相关不良反应的患者,以便系统地停用这些高风险药物。

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