Ciorciaro C, Hartmann K, Kuhn M
Schweizerische Arzneimittelnebenwirkungszentrale (SANZ), Chur.
Schweiz Med Wochenschr. 1998 Feb 14;128(7):254-8.
The risk of presenting adverse drug reactions (ADR) is greater for elderly patients. Chronological age is not an independent risk factor for ADRs, but age-dependent factors such as polymedication, multiple diseases and changes in pharmacokinetics and pharmacodynamics seem to be responsible for the risk of developing more adverse drug reactions. We analyzed the ADRs spontaneously reported to the Swiss Drug Monitoring Centre (SANZ) between 1981 and 1995. Age-specific relative incidences of the reported ADRs affecting different organ systems were calculated. For elderly patients we found a decrease in the relative incidence of dermatological ADRs and an increase in neuropsychic and hematological ADRs. The incidence of serious ADRs increased by 8.7% in older patients (> 70 years). The results of this analysis of spontaneous reports were inconsistent with results from epidemiological studies. The possibility and reasons for under-reporting ADRs occurring in elderly patients are discussed.
老年患者出现药物不良反应(ADR)的风险更高。实际年龄并非ADR的独立风险因素,但诸如多药合用、多种疾病以及药代动力学和药效学变化等与年龄相关的因素似乎是导致发生更多药物不良反应风险的原因。我们分析了1981年至1995年间自发向瑞士药物监测中心(SANZ)报告的ADR。计算了影响不同器官系统的报告ADR的年龄特异性相对发生率。对于老年患者,我们发现皮肤ADR的相对发生率下降,而神经精神和血液学ADR的相对发生率上升。老年患者(>70岁)严重ADR的发生率增加了8.7%。对自发报告的分析结果与流行病学研究结果不一致。讨论了老年患者中ADR报告不足的可能性及原因。