Diamond J P
Bristol Eye Hospital, England.
Drugs Aging. 1997 Nov;11(5):352-60. doi: 10.2165/00002512-199711050-00003.
Topical ophthalmic medications are widely prescribed by growing numbers of eye-care professionals. Increasingly, these agents are being prescribed by optometrists and ophthalmic-trained nurses in addition to ophthalmologists and general practitioners. As the number and variety of topical agents on the market rises, and as the number of clinicians involved in prescribing those agents increases; the risk of systemic adverse effects will also increase. Thus, professionals involved in the care of these patients must be aware of the risks associated with these drugs in order to minimise the likelihood of complications. Moreover, inadequate training may result in the clinician failing to associate a topical medication with a systemic condition, allowing an adverse effect to pass unrecognised. It is therefore in the interest of the ophthalmic and pharmaceutical communities to improve awareness of the potential dangers intrinsic in the use of topical eye medications. It is the elderly population who are at greatest risk of experiencing systemic adverse effects of topical agents. Chronic ophthalmic diseases, and hence long term ophthalmic drop treatments, are more prevalent among older people. Such individuals are also likely to have other medical conditions (e.g. cardiac, respiratory or neurological disease) that may be induced or exacerbated by topical ophthalmic agents. Moreover, polypharmacy is common in elderly people, and this is associated with an increased risk of drug interactions.
越来越多的眼保健专业人员广泛开具局部用眼科药物。除眼科医生和全科医生外，验光师和接受过眼科培训的护士也越来越多地开具这些药物。随着市场上局部用药的数量和种类增加，以及开具这些药物的临床医生数量增多，全身不良反应的风险也会增加。因此，参与这些患者护理的专业人员必须了解这些药物相关的风险，以尽量减少并发症的发生可能性。此外，培训不足可能导致临床医生无法将局部用药与全身性疾病联系起来，从而使不良反应未被识别。因此，提高对局部用眼科药物潜在危险的认识符合眼科和制药界的利益。老年人群是局部用药出现全身不良反应风险最高的人群。慢性眼科疾病，以及因此需要长期使用眼药水治疗的情况，在老年人中更为普遍。这类人群也可能患有其他疾病（如心脏、呼吸或神经系统疾病），这些疾病可能由局部用眼科药物诱发或加重。此外，老年人多重用药很常见，这与药物相互作用风险增加有关。
