与严重跌倒事件的年龄相关风险和阿片类止痛药的使用
Ria E Hopkins1, Chrianna Bharat1, Luke Buizen1
1National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia.
JAMA internal medicine
|February 19, 2024
概括
阿片类止痛药增加了成年人严重跌倒的风险,特别是85岁及以上的人. 最高的风险发生在开始服用阿片类药物的28天内,较高的剂量与更多的跌倒有关.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 片类止痛药经常被处方,但它们与跌倒风险的关联,特别是老年人,需要进一步量化.
- 了解与年龄相关的风险和特定的暴露模式对于患者的安全至关重要.
研究的目的:
- 量化与处方阿片类药物暴露相关的严重跌倒事件的年龄相关风险.
- 分析阿片类药物开始和每日剂量对跌倒风险的影响.
主要方法:
- 澳大利亚的一项以人口为基础的队列研究 (POPPY II) 将药品声明与开始阿片类药物治疗的成年人的健康记录联系起来.
- 负二项式模型评估了依赖时间的阿片类药物暴露,年龄和严重的跌倒事件之间的关联,并根据已知的风险因素进行调整.
主要成果:
- 这项研究包括超过320万个人开始服用阿片类药物治疗.
- 在所有年龄组中,阿片类药物暴露增加了严重跌倒的风险,在85岁及以上的人群中观察到的风险最高 (IRR 6.35).
- 在阿片类药物开始后的前28天内注意到风险增加,并且与18-84岁的成年人每日更高的剂量相关.
结论:
- 处方阿片类药物与成年人严重跌倒事件的风险增加有关,老年人最容易受到伤害.
- 处方医生应该考虑跌倒的风险,特别是对于老年患者,那些有先前存在的疾病,或在较高的阿片类药物剂量.
- 针对性防摔策略可能在阿片类药物治疗的最初一个月内最有益.
更多相关视频
07:27Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
Published on: October 6, 2016
10.3K
04:13Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults
Published on: February 8, 2019
6.8K
相关概念视频
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
250
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
250
01:25Analgesia and Pain Management
623
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
623
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
299
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
299
01:29Bone Disorders
3.5K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
3.5K
01:28Depressants
116
Depressant drugs, including alcohol and sedative-hypnotics, diminish central nervous system activity by enhancing the action of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces brain activity and promotes relaxation. These substances can have various therapeutic uses but also pose significant risks, especially when misused or combined.
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
116
01:02Prescription, Nonprescription and Orphan Drugs
728
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
728