Kurfees J F, Dotson R L
Department of Family Practice, University of Louisville, School of Medicine, KY 40292.
J Fam Pract. 1987 Nov;25(5):477-88.
Polypharmacy and its dangers in the elderly are of increasing concern. The purpose of this study was to determine the incidence of drug with drug, drug with food, and drug with alcohol interactions in a population aged 60 years or greater. Four hundred patients were randomly selected from a university family medicine outpatient clinic population of 4,483 in this age group. A total of 292 drugs were involved for a total of 1,052 potential interactions: 310 drug-food, 316 drug-alcohol, and 426 drug-drug. Interactions were analyzed using The Drug Master computer program and rated as to their clinical significance. Chart review revealed no serious actual interaction for any patient even though potential interactions could be categorized as highly significant for 27 percent of the drug-drug, 11 percent of the drug-alcohol, and 3 percent of the drug-food. Thirty-two percent of the total population were taking five or more drugs concurrently. The mean number of drugs for men was 3.75 and for women 4.22 (P less than .05). Age and race differences were also noted in the number of drugs taken. The most common drugs and their interactions with drug, food, and alcohol are reviewed.
老年患者的多重用药及其风险日益受到关注。本研究的目的是确定60岁及以上人群中药物与药物、药物与食物、药物与酒精之间相互作用的发生率。从该年龄组4483名大学家庭医学门诊患者中随机选取400例患者。共涉及292种药物，总计1052种潜在相互作用：310种药物与食物相互作用、316种药物与酒精相互作用、426种药物与药物相互作用。使用药物主计算机程序对相互作用进行分析，并对其临床意义进行评级。病历审查显示，尽管27%的药物与药物相互作用、11%的药物与酒精相互作用、3%的药物与食物相互作用的潜在相互作用可被归类为高度显著，但没有任何患者出现严重的实际相互作用。32%的总人口同时服用五种或更多药物。男性平均用药数量为3.75种，女性为4.22种（P<0.05）。在用药数量上还注意到年龄和种族差异。本文对最常用药物及其与药物、食物和酒精的相互作用进行了综述。
