多态细胞染色体P450酶通路与多种药物治疗的老年人倒的关联
Katja S Just1, Laura M Pott1, Jakob Sommer1
1Institute of Clinical Pharmacology, University Hospital RWTH Aachen, Aachen, Germany.
Journal of the American Medical Directors Association
|September 5, 2024
概括
通过CYP2C19的药物代谢与老年人跌倒有关,特别是与非跌倒风险增加药物有关. 针对CYP2C19基质的个性化药物可以防止跌倒.
科学领域:
- 老年学是指老年学的学科.
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
背景情况:
- 与药物相关的跌倒在老年人中是一个重大问题.
- 药物代谢受酶活性和药物遗传学等因素的影响,在药物不良事件中起作用.
研究的目的:
- 调查药物代谢特征,特别是细胞P450 (CYP) 酶活性和药物遗传学之间的联系,以及社区居住的老年人中跌倒的发生.
主要方法:
- 一项基于人口的前性研究 (ActiFE-Ulm) 分析了1377名老年人超过1年.
- 专注于CYP2C19,CYP2C9和CYP2D6代谢,分析药物基因变异.
- 逻辑回归计算了基于药物代谢表型的跌倒概率比率.
主要成果:
- 通过CYP2C19代谢的药物的使用与跌倒有关,即使对于非跌倒风险增加药物 (OR 1.46).
- 降低的CYP2C19活性表型显著改变了CYP2C19代谢的非跌倒风险增加药物对跌倒发生的影响.
结论:
- 在老年人中,CYP2C19代谢能力与跌倒有关.
- 对CYP2C19基质 (例如抗抑郁药,PPI) 的个性化剂量和持续时间可能对预防跌倒至关重要,特别是在低和中等代谢者中.
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