Wiedemann Andreas, Dündar Vedat, Heese Melanie, Leufgens Thomas, Wirz Stefan, Brauckmann Robin, Heppner Hans-Jürgen
Urologische Abteilung, Evangelisches Krankenhaus Witten.
Lehrstuhl für Geriatrie, Universität Witten/Herdecke.
Aktuelle Urol. 2021 Sep;52(5):481-489. doi: 10.1055/a-1352-9370. Epub 2021 May 31.
The urinary tract is the site of many adverse drug reactions, including the formation of residual urine, urinary retention, pollakisuria, polyuria, nycturia, detrusor stimulation, detrusor inhibition, haematuria, dysuria and other symptoms. Nevertheless, there is no general overview or evaluation of the substances that can trigger these adverse drug reactions. The available lists of "potential inadequate medication" either focus on a pharmacological group of adverse reactions ("anticholinergic burden score"), a group of drugs for a specific indication (LUTS-Forta) or on a selected group of patients (PRISKUS List, Beers List).The following interdisciplinary project has been processed by the group for urogeriatrics in the University of Witten/Herdecke and is intended to fill this gap. We have identified substances which can in principle trigger adverse reactions in the urinary tract - according to a variety of databases. We also categorise the available literature (case reports, case series, RCT, meta-analysis) and present a structured analysis of the risk by 33 experts. This results in a list of 235 substances that can lead to various different adverse reactions of the urinary tract. This list includes a "theoretical" score from the reports in the databases or the corresponding literature, a "practical" score based on an expert evaluation of clinical reality and a cumulative score, classified in accordance with the Rote Liste".It is now possible to classify the extent to which newly prescribed drugs may pose a risk of adverse reactions in different patients. Conversely, this may also help to clarify whether a functional disorder of the urinary tract is fully or partially linked to treatment with a specific drug. We plan to develop an app to assess adverse drug reactions in the urinary tract.
尿路是许多药物不良反应的发生部位,包括残余尿形成、尿潴留、尿频、多尿、夜尿、逼尿肌刺激、逼尿肌抑制、血尿、排尿困难等症状。然而,对于能够引发这些药物不良反应的物质,目前尚无全面的概述或评估。现有的“潜在不适当用药”清单要么侧重于某一药理学不良反应组(“抗胆碱能负担评分”)、某一特定适应症的一组药物(LUTS - Forta),要么侧重于某一选定的患者群体(PRISKUS清单、Beers清单)。维滕/黑尔德克大学的老年泌尿病学小组开展了以下跨学科项目,旨在填补这一空白。我们根据各种数据库确定了原则上可在尿路引发不良反应的物质。我们还对现有文献(病例报告、病例系列、随机对照试验、荟萃分析)进行了分类,并由33位专家对风险进行了结构化分析。这得出了一份包含235种物质的清单,这些物质可导致尿路的各种不同不良反应。该清单包括来自数据库报告或相应文献的“理论”评分、基于专家对临床实际情况评估的“实际”评分以及根据《德国药品索引》分类的累积评分。现在可以对新开具的药物在不同患者中引发不良反应的风险程度进行分类。反之,这也有助于明确尿路功能障碍是否完全或部分与特定药物治疗有关。我们计划开发一款应用程序来评估尿路中的药物不良反应。