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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Drug Therapy01:28

Drug Therapy

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
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When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
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It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
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多剤併用、外来処方、および外傷性脳損傷のリスク：系統的レビュー

Hadjer Dahel1, Han Ting Wang2, Christophe Dumais2

  • 1Faculté de pharmacie, Université de Montréal, Montreal. Canada; Hôpital du Sacré-Coeur de Montréal, CIUSSS NÎM research center, Montreal, Canada.

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まとめ

抗精神病薬、抗うつ薬、睡眠薬、オピオイドなどの特定の薬剤は、外傷性脳損傷（TBI）のリスク増加と関連している。抗血栓薬のTBIリスクへの影響は依然として一貫性がなく、特に高齢者においてはさらなる調査が必要である。

キーワード:
抗精神病薬抗血栓薬多剤併用鎮静薬TBIZ drugs

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科学分野:

  • 神経科学
  • 薬理学
  • 疫学

背景:

  • 外傷性脳損傷（TBI）の発生率は高齢者で増加している。
  • 薬剤の使用は、TBIの修正可能な危険因子である。
  • 特定の薬剤とTBIリスクに関する研究は限られている。

研究 の 目的:

  • 特定の薬剤使用、多剤併用、およびTBIリスクとの関連を系統的にレビューすること。
  • TBI予防戦略および将来の研究の方向性に情報を提供すること。

主な方法:

  • PROSPEROに登録されたPRISMAガイドラインに従った系統的レビュー。
  • 複数のデータベース（MEDLINE、EMBASE、PsycINFOなど）を検索した。
  • 薬剤とTBIリスクに関するRCT、準実験的研究、および観察研究を含めた。小児およびTBI以外の外傷研究は除外した。

主要な成果:

  • 16件の研究が包含基準を満たし、7つの薬剤クラスと27の単一薬剤を調査した。
  • 抗精神病薬、抗うつ薬、ベンゾジアゼピン、オピオイド、および抗不整脈薬は、TBIリスクの増加と関連していた。
  • 抗血栓薬およびZ drugsの結果は、研究間で一貫性がなかった。

結論:

  • 抗精神病薬、抗うつ薬、睡眠薬、およびオピオイドは、TBIリスクの増加と関連している。
  • TBIリスクとの抗血栓薬の関連については、さらなる研究が必要である。
  • 特に高齢者におけるTBIの薬剤リスクに関するさらなる研究が必要である。