Rajendran Yazhini, Keche Yogendra, Gaikwad Nitin R, Dhaneria Suryaprakash
Pharmacology, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Pharmacology and Therapeutics, Ruxmaniben Deepchand Gardi Medical College, Ujjain, IND.
Cureus. 2024 Feb 7;16(2):e53767. doi: 10.7759/cureus.53767. eCollection 2024 Feb.
Background The elderly population differs from adults in having various physiological changes and multiple diseases, which demand the use of multiple medications. The practice of polypharmacy in the elderly leads to numerous harmful effects like adverse drug reactions, adverse drug-drug interactions (DDIs), poor compliance, etc. Methodology This study collected 295 case files of elderly patients retrospectively in the Departments of General Medicine, Cardiology and Nephrology after obtaining Institute Ethics Committee approval to look for the potential adverse DDIs with their severity according to the clinical significance. Results and interpretation The total number of adverse DDIs identified was 156, the maximum in Category 'C.' Salbutamol plus carvedilol/propranolol, ramipril plus telmisartan and ivabradine plus diltiazem were the adverse DDIs categorized under severity 'X'. The identified DDIs were categorised according to the mechanism such as increased bleeding risk, hypokalemia, hyperkalaemia, reduced effect of drugs and increased effect of drugs. Conclusion Polypharmacy can lead to several adverse consequences in the elderly, of which adverse DDIs play a crucial role in harmful health outcomes. This study brings out the significance of predicting drug interactions beforehand which can reduce the risk of bleeding and other risks of hyper/hypokalaemia, hyponatremia and hypoglycaemia.
老年人群与成年人不同,他们存在各种生理变化且患有多种疾病,这需要使用多种药物。老年人的多重用药行为会导致许多有害影响,如药物不良反应、药物相互作用不良(DDIs)、依从性差等。方法:本研究在获得机构伦理委员会批准后,回顾性收集了普通内科、心脏病科和肾内科295例老年患者的病例档案,以根据临床意义寻找潜在的不良药物相互作用及其严重程度。结果与解读:确定的不良药物相互作用总数为156例,其中“C”类最多。沙丁胺醇加卡维地洛/普萘洛尔、雷米普利加替米沙坦以及伊伐布雷定加地尔硫䓬属于严重程度为“X”的不良药物相互作用。确定的药物相互作用根据其机制进行分类,如出血风险增加、低钾血症、高钾血症、药物效果降低和药物效果增强。结论:多重用药会给老年人带来多种不良后果,其中不良药物相互作用在有害健康结局中起关键作用。本研究凸显了预先预测药物相互作用的重要性,这可以降低出血风险以及高/低钾血症、低钠血症和低血糖等其他风险。