Center for Pharma-Food Research (CPFR), Graduate School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan.
Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Japan.
Geriatr Gerontol Int. 2024 Mar;24 Suppl 1:81-87. doi: 10.1111/ggi.14706. Epub 2023 Oct 23.
Older adults frequently have many systemic diseases that require treatment with multiple drugs, and thus anticholinergic adverse effect by polypharmacy is a significant concern in the management of older adults. The accuracy of the anticholinergic burden rating may be increased by considering pharmacokinetic and pharmacodynamic factors such as biophase drug concentrations, the pharmacologically active metabolites formed after drug administration, and muscarinic receptor-mediated effects. Therefore, a pharmacological evidence-based burden scale that considers pharmacokinetic and pharmacodynamic factors is expected to be a more optimal tool for precisely assessing the anticholinergic burden, specifically risk reductions in anticholinergic adverse events in the poly-medicated elderly. Geriatr Gerontol Int 2024; 24: 81-87.
老年人常患有多种需要多种药物治疗的系统性疾病，因此，药物治疗引起的抗胆碱能不良反应是老年人管理中的一个重要问题。通过考虑药代动力学和药效动力学因素，如生物相药物浓度、药物代谢后的药理活性代谢物以及毒蕈碱受体介导的效应等，可以提高抗胆碱能负担评分的准确性。因此，考虑药代动力学和药效动力学因素的药理学循证负担量表有望成为更精确评估抗胆碱能负担的更优工具，特别是可以降低多药治疗的老年患者发生抗胆碱能不良反应的风险。《老年医学与老年健康国际杂志》2024 年；24: 81-87.
