Yamaguchi Takuya, Aihara Akinobu, Mashiko Shigeto, Kurosawa Emiko, Oizumi Tomoya, Yamagata Toshihiro, Ishiki Aiko, Ueda Juri, Fujikawa Yuko, Kanno Atsuhiro, Sumitomo Kazuhiro, Ohara Takahiro, Furukawa Katsutoshi
Division of Geriatric and Community Medicine, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Front Med (Lausanne). 2024 Jul 18;11:1415988. doi: 10.3389/fmed.2024.1415988. eCollection 2024.
Parkinson's disease (PD) is a disorder characterized by motor symptoms, such as rigidity, akinesia, and resting tremor, as well as non-motor symptoms, including psychiatric manifestations and autonomic failure. The prevalence of PD increases with age, and the condition is more common in men than in women. Conversely, polypharmacy has emerged as a paramount medical concern, especially among older patients, correlating with medicines' adverse effects, interactions between medicines, frequent admissions to the hospital, and a high risk of morbidity and mortality.
We encountered an older male patient with idiopathic PD and mild renal dysfunction. Originally prescribed 14 types of medicines, including anti-PD drugs, the patient developed delirium and epileptic seizures during hospitalization. After reducing the number of medications, including amantadine, the symptoms significantly improved. This clinical course suggests that polypharmacy, in addition to PD itself, poses a significant risk of delirium and epileptic seizures, even in patients with mild renal dysfunction.
This report is indicative of the risk of polypharmacy and highlights the importance of citing drug interactions for a correct diagnosis in patients presenting with complex symptoms.
帕金森病(PD)是一种以运动症状为特征的疾病,如僵硬、运动不能和静止性震颤,以及非运动症状,包括精神表现和自主神经功能衰竭。PD的患病率随年龄增长而增加,且该疾病在男性中比在女性中更常见。相反,多重用药已成为一个至关重要的医学问题,尤其是在老年患者中,这与药物的不良反应、药物间相互作用、频繁住院以及高发病和死亡风险相关。
我们遇到一位患有特发性PD和轻度肾功能不全的老年男性患者。最初给他开了14种药物,包括抗PD药物,该患者在住院期间出现了谵妄和癫痫发作。在减少包括金刚烷胺在内的药物数量后,症状明显改善。这一临床过程表明,除了PD本身外,多重用药即使在轻度肾功能不全的患者中也会带来显著的谵妄和癫痫发作风险。
本报告表明了多重用药的风险,并强调了在有复杂症状的患者中考虑药物相互作用以进行正确诊断的重要性。