潜在的不适当的药物使用和多药在老年患者内科治疗前后
Freyja Jónsdóttir1, Anna B Blöndal2, Aðalsteinn Guðmundsson3
1Pharmaceutical Sciences, University of Iceland, Reykjavik; Pharmacy Services, Landspitali - The National University Hospital of Iceland, Reykjavik.
The American journal of medicine
|August 2, 2024
概括
在老年人中,潜在的不适当的药物使用是很常见的,特别是那些有多药的人. 对老年人来说,审查药物的适当性至关重要,以减少风险.
科学领域:
- 老年医学 老年医学
- 药学流行病学 药学流行病学
- 内部医学 内部医学
背景情况:
- 人口老龄化和慢性疾病增加增加了多药和不适当药物使用的风险.
- 潜在不合适的药物 (PIM) 使用是老年人医疗保健的一个重大问题.
- 多药性,即同时使用多种药物,加剧PIM风险.
研究的目的:
- 确定老年人潜在不适当药物使用的流行率和发病率.
- 调查多药和可能不适当的药物使用之间的相关性.
- 为了确定与新潜在不合适的药物使用相关的因素,在出院后使用.
主要方法:
- 从2010年至2020年住院的65岁以上患者的回顾性,基于人口的队列研究.
- 从国家处方药登记处获得的药物数据.
- 使用2019年Beers标准评估的潜在不合适的药物使用;多药性按药物数量定义 (非多药性<5,多药性5-9,超多药性≥10).
主要成果:
- 在入院前使用PIM的流行率为34.0% (非多药),77.7% (多药) 和96.4% (超多药).
- 出院后新使用PIM的发生率为46.7%.
- 与增加新PIM使用几率相关的因素包括多剂量分发,痴呆症,多药和超多药.
结论:
- 在老年住院患者中,潜在的不适当药物使用的流行率和发病率很高.
- 多药学与潜在的不适当药物使用的增加有很强的相关性.
- 加强对药物适宜性的审查和重新评估对于内部医学机构中老年人至关重要.
相关概念视频
01:28Drug Therapy
41
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.
Antianxiety Medications
Antianxiety Medications
41
01:21Factors Affecting Drug Response: Overview
1.9K
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...
1.9K
01:30Guidelines for Nursing Documentation I
1.0K
Quality documentation and reporting share essential characteristics that ensure they are practical and valuable resources for those who use them. These characteristics are:
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
1.0K
01:11Renal Failure: Dose Adjustments
77
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...
77
01:15Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
53
Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
53
01:15Drug Dosage Regimen: Overview
3.5K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
3.5K