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少即是多——当前研究中老年及老年患者用药实例

[Less can be more-Examples on medication in older and geriatric patients from current studies].

作者信息

Thiem U, Heppner H J, Sieber C

机构信息

Lehrstuhl für Geriatrie und Gerontologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.

Zentrum für Altersmedizin, Medizinisch-Geriatrische Klinik, Albertinen-Haus, Sellhopsweg 18-22, 22459, Hamburg, Deutschland.

出版信息

Internist (Berl). 2021 Apr;62(4):363-372. doi: 10.1007/s00108-021-00981-7. Epub 2021 Feb 25.

Abstract

Polypharmacy, i.e. the prescription of five or more different drugs for medicinal treatment, is a typical problem in older and geriatric patients. Polypharmacy predisposes to different negative health sequelae, such as undesired side effects, drug interactions, potentially inappropriate medication, reduced functional abilities, increased hospitalization and increased mortality. Various consensus groups and specialist societies have developed recommendations on how to handle polypharmacy in geriatric patients. Although concepts to reduce the number of drugs are considered necessary, in many areas there is a lack of evidence on how to limit polypharmacy in geriatric patients and to reduce and discontinue medication. This article presents examples of recent studies dealing with potentially inappropriate medication, vitamin D substitution and antipsychotic drugs, which show how to critically appraise a prescribed medication, to critically check the indications for drugs and to discontinue drug use.

摘要

多重用药,即开具五种或更多不同药物用于药物治疗,是老年患者中的一个典型问题。多重用药易引发不同的负面健康后果,如不良副作用、药物相互作用、潜在不适当用药、功能能力下降、住院率增加和死亡率上升。多个共识小组和专业协会已就如何处理老年患者的多重用药问题制定了建议。尽管减少药物数量的理念被认为是必要的,但在许多领域,缺乏关于如何在老年患者中限制多重用药以及减少和停用药物的证据。本文列举了近期关于潜在不适当用药、维生素D替代治疗和抗精神病药物的研究实例,这些实例展示了如何严格评估处方药物、严格检查用药指征以及停用药物。

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