在老年退伍军人中使用他类药物治疗的模式和相关结果跨功能
Grenita Gjyriqi1, Adam Gross2, Edith Burns1
1Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY.
The American journal of medicine
|April 4, 2024
概括
在75岁以上的成年人中,他类药物治疗没有影响痴呆风险,但显示出22%的生存益处. 在这项大型队列研究中,功能没有改变这些结果.
科学领域:
- 老年学是一门学科.
- 心血管医学 心血管医学
- 神经学 神经学
背景情况:
- 动脉样性心血管疾病对健康构成重大风险.
- 老年人经常被排除在主要的他类药物治疗试验之外.
- 有限的数据存在于75岁及以上的个人对他类药物的影响.
研究的目的:
- 评估开始他类药物治疗对75岁以上成年人痴呆发病率的影响.
- 评估他类药物治疗对该年龄组所有原因死亡率的影响.
- 为了检查功能全方位的这些影响.
主要方法:
- 对640,191名75岁以上的VA医疗系统患者进行了回顾性队列研究.
- 分析了对病例痴呆症和全因死亡率的分析.
- 考克斯的比例危险分析被用来确定关联.
主要成果:
- 没有他类药物组的痴呆发病率为4.7%,而他类药物组的发病率为3.2%.
- 达丁类药物治疗与22%的死亡率益处有关.
- 不同的功能水平之间没有观察到显著的治疗效果.
结论:
- 在老年人 (75岁以上) 中,启动他类药物治疗与发生痴呆症无关.
- 与非使用者相比,静止剂使用者表现出显著的生存优势.
- 建议对不同种群进行进一步的研究,以验证这些发现.
相关概念视频
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
659
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
659
Renal Failure: Dose Adjustments
88
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
88
Renal Drug Excretion: Overview
153
As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
153
Factors Affecting Renal Clearance: Renal Impairment
91
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
91
Renal Drug Clearance: Overview
186
Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
186
Renal Drug Excretion: Tubular Secretion
180
Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
180


