Chadli Zohra, Kasraoui Kmar, Hannachi Ibtissem, Chaabane Amel, Klii Rim, Ben Romdhane Haifa, Boughattas Naceur A, Ben Fredj Nadia, Aouam Karim
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia.
Internal Medicine Department, University Hospital of Monastir, Tunisia.
Tunis Med. 2024 Oct 5;102(10):682-689. doi: 10.62438/tunismed.v102i10.4970.
Introduction-Aim: The iatrogenic risk in the elderly is a real public health problem due to its frequency and seriousness. Our study aimed to analyze the epidemiological, clinical and chronological aspects of adverse drug reactions occurring in elderly subjects and to identify the incriminated drugs.
We carried out a retrospective study of all the observations of adverse drug reactions in elderly subjects, notified to the Clinical Pharmacology department of Monastir over a period of 17 years (2004 - 2020). Drug skin tests were performed according to ENDA recommendations and imputability was analyzed using the French method of Bégaud et al. The drugs have been grouped according to the ATC classification.
Among 545 events occurring in elderly subjects, drug responsibility was retained in 209 patients. They were 106 men and 103 women (gender-ratio=1.03). The average age of the patients was 72.3±6 years. Drug hypersensitivity reactions accounted for 75% of all adverse effects. The majority of these reactions were type IV (delayed). The incriminated drugs were: anti-infectives (47%), drugs for the musculoskeletal system (20%), drugs for the cardiovascular system (17%) and drugs for the central nervous system (5%).
Through this study, we noted a predominance of delayed drug hypersensitivity reactions as well as an increased involvement of anti-infectives and allopurinol in the occurrence of adverse effects in the elderly population.
引言 - 目的:由于医源性风险在老年人中出现的频率和严重性,它已成为一个切实的公共卫生问题。我们的研究旨在分析老年患者中发生的药物不良反应的流行病学、临床和时间方面,并确定相关药物。
我们对在17年期间(2004 - 2020年)通报给莫纳斯提尔临床药理学部门的所有老年患者药物不良反应观察病例进行了回顾性研究。根据ENDA建议进行药物皮肤试验,并使用法国Bégaud等人的方法分析可归责性。药物已根据ATC分类进行分组。
在老年患者发生的545起事件中,确定有209名患者的药物责任成立。其中男性106名,女性103名(性别比 = 1.03)。患者的平均年龄为72.3±6岁。药物过敏反应占所有不良反应的75%。这些反应大多为IV型(迟发型)。相关药物为:抗感染药(47%)、肌肉骨骼系统用药(20%)、心血管系统用药(17%)和中枢神经系统用药(5%)。
通过这项研究,我们注意到迟发型药物过敏反应占主导地位,以及抗感染药和别嘌醇在老年人群不良反应发生中的参与度增加。