在考虑基于实体数据支持的药理动力学-药理动力学建模和仿真方法的量化益处风险评估的老年患者中适当使用亚
Akira Okada1,2, Shoji Sera3,4, Naomi Nagai3,4
1Laboratory of Regulatory Science, Faculty of Pharmacy, Musashino University, 1-1-20 Shinmachi, Nishitokyo-shi, Tokyo, 202-8585, Japan. akiokada@musashino-u.ac.jp.
由于增加不良事件风险,老年人使用triazolam需要谨慎剂量. 建议降低0.125毫克的剂量,特别是与CYP3A抑制剂结合使用时,以确保患者的安全.
科学领域:
- 药理学 药理学是指药理学的学科.
- 老年病的医生 老年病的医生
- 药品安全 药品安全
背景情况:
- 特里亚佐拉姆经常被处方给老年患者.
- 有关因年龄相关的生理变化和药物相互作用而导致的不良事件存在担忧.
- 更新有关老年人安全使用三胺的信息至关重要.
研究的目的:
- 评估三胺在老年人中的适当使用.
- 将现实世界的数据与模型和模拟集成在一起,以优化三胺治疗.
- 在老年人群中评估与三胺相关的风险.
主要方法:
- 利用来自日本和美国的自发不良事件报告数据库.
- 从出版物中提取药物度和反应数据,以确定不良事件值.
- 构建了一个药理动力学/药理动力学 (PK/PD) 模型来评估剂量策略.
主要成果:
- 老年人,特别是70岁以上和80岁以上的老年人,经常接受三胺,通常与CYP3A代谢药物一起服用.
- 在老年 triazolam 用户中观察到 Delirium 和跌倒骨折的风险增加.
- 在PK/PD模型中,当三胺的血度在给药6小时后超过0.44 ng/mL时,就会增加不良事件的风险.
- 一剂0.125毫克的三胺被认为是适当的,即使在0.0625毫克与CYP3A抑制剂结合使用时,也发现了显著的风险.
结论:
- 大规模的数据分析和PK/PD建模可以优化对老年人的三胺治疗.
- 临床实践可以从对 triazolam 在老年人中的安全性概况的最新见解中受益.
- 提供了对老年人更安全的三胺剂量的建议.
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