Le Jeunne C, Hugues F C
Service de Médecine Interne II et de Thérapeutique, Hôpital Laennec, Paris, France.
Therapie. 1995 May-Jun;50(3):247-52.
Elderly people are particularly at risk for drug interactions, for several reasons. They are the part of the population who consume the most drugs: over 75 years the mean number of drugs on a prescription is 5.6. As they suffer from various associated diseases, they see several medical specialists, each of them adding a new prescription to the others. Self-prescriptions complicate the problem because they are rarely mentioned. Changes in pharmacokinetics in the elderly tend to increase blood concentrations of drugs. Elderly people suffer from altered homeostatic mechanisms to compensate for adverse drug effects. As a whole, such individuals are more exposed to the side effects of drugs. The drugs most often involved in these interactions are diuretics, non-steroidal anti-inflammatory drugs, benzodiazepines, antiarrhythmics, cardiac glycosides, antihypertensive drugs, oral antidiabetics and antalgics. The clinical accidents most often occurring with these drug interactions are: malaise, orthostatic hypotension, loss of conciousness, amnesia, confusion, renal insufficiency, digestive problems. Since elderly people are less likely to recover easily, this problem of drug interaction should be looked for systematically.
老年人尤其容易发生药物相互作用，原因有以下几点。他们是用药最多的人群：75岁以上人群每张处方的平均用药数量为5.6种。由于他们患有多种相关疾病，会看多个专科医生，每个医生都会在其他医生开的药方基础上再增加新的处方。自我用药使问题更加复杂，因为这很少被提及。老年人药代动力学的变化往往会使药物的血药浓度升高。老年人的体内平衡机制发生改变，难以代偿药物的不良反应。总体而言，这类人群更容易受到药物副作用的影响。这些相互作用中最常涉及的药物有利尿剂、非甾体抗炎药、苯二氮䓬类药物、抗心律失常药、强心苷、抗高血压药、口服降糖药和镇痛药。这些药物相互作用最常引发的临床意外情况有：不适、体位性低血压、意识丧失、失忆、意识模糊、肾功能不全、消化问题。由于老年人不容易轻易康复，因此应系统地排查药物相互作用问题。
